#PTonICE Podcast

Discussion on current protein recommendations and potential changes, study findings on protein synthesis limits after exercise, alternative protein feeding strategies, and the significance of protein intake for athletes and patients.

Dr. Jeff Moore // #LeadershipThursday // www.ptonice.com  In today's episode of the PT on ICE Daily Show, ICE Chief Executive Officer Jeff Moore discusses the differences in how regret can present from overworking an unrewarding job, but also from underworking in a career with a lot of potential for both personal & professional impact. Take a listen to the podcast episode or check out the full show notes on our blog at www.ptonice.com/blog. 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 JEFF MOOREAlright team, what's up? Welcome back to the PT on Ice Daily Show. Thrilled to be here on Leadership Thursday. I am Dr. Jeff Moore, currently serving as the CEO of ICE and always pumped to be here on Leadership Thursday, which always pairs as a Gut Check Thursday. Let's get right into it and talk about the workout. So what we've got is the CSM workout. Both Alan Fredendahl and Paul Kalorin of Ice and iDryNeedle, the combo, are going to be there to lead you all through a workout Saturday morning. Anybody at CSM who wants to get some movement in, please join us. 5 a.m. CrossFit Southie. You've got to sign up on the form. So go to the Ice Students page. The form is on there. It's here on Instagram. It's on the pinned post for the CSM WOD. I think we have like 20 signups and I want to say they're taking in 30 or 40 so as we get very near to Saturday morning make sure you jump on there if you indeed want to work out. It's going to look like this should you choose to attend. It is going to be an AMRAP 25 minutes. Now mind you, anybody not at CSM should still do this. Teams of 2. We've got a 100 calorie row. We've got 80 alternating hang dumbbell snatches at the usual 50-35. You've got 60 box jump overs at 24-20. You've got 40 toes to bar, and then finishing off with 20 burpees over a dumbbell, and then going back up to the top, should you have more time in your 25 minutes. Should be a really nice chipper running through that. Gonna get kind of a one-to-one work-rest ratio. Should be able to keep moving. Should be an awesome workout. If you go to the CSM workout, please make sure to tag us. I won't be there, so I'd love to see photos and videos of all of you getting after it. Let's jump into Leadership Thursday. DEATHBED REGRETS The topic is deathbed regret. Will you have them? I think perhaps not. Let me explain. So the usual story goes something like this, and I think we've got to respectfully counter it. The usual story goes something like this. Your grandfather or your grandparents in their twilight years are regretting spending too much time at the office. right, saying, you know, oh, I wish I would have pursued more of my hobbies, done more things that I really cared about, et cetera, et cetera, et cetera. And the cautionary tale here that we're supposed to pull away from this constantly heard story is that you shouldn't overwork, okay? This is the concern, this is the moral of the story, if you will. REGRET FROM OVERWORKING Okay, I don't know about you all, but my grandfather worked in paint factories in downtown Detroit, Michigan. Tough gig, tough city, right? But he did what he had to do. I have no doubt, given the option, he would look back and say, I never asked him, but I'm sure he would have looked back and said, I wish I could have done a bit more of that. Or I wish I would have chose to, if there were sufficient resources, do a little bit less of that and spend less time there. I have no doubt about that. That's fair. If your job feels like that, like it's tough, it's grindy, it's not necessarily one that you're super passionate about it. You're kind of doing it because you have to, but you can't change that because you're doing what you have to do. That's the job that's available to you and you're getting it done because that's your responsibility. Not only is that noble, but it's totally understandable to do what you need to do, but I would agree, maybe don't do a ton extra. And I can totally appreciate how regret at end of life could come should you choose to do a ton extra of something you don't necessarily love. I will cough that up. I will agree with that. I can appreciate why that's been the narrative for a lot of years. That being said, It is much more likely that you are doing something that you chose and that you are passionate about and that you love. Particularly if you're sitting here on Thursday morning, taking in leadership Thursday, the odds are really good that you chose your career amongst a variety of options and you chose one that you believe in, right? You probably didn't choose the paint factory in downtown Detroit. It's a tough gig, right? That probably isn't one you were drawn to. And again, if you're in this ethos, where you're taking in this kind of content, you're probably in a position where you chose something you loved. Now, if you started a company, or you joined a company that you really believe in, regret is unlikely going to be the byproduct of your hard work in that space. So what I'm saying is that we need to advocate, or I wanna advocate, for a shift from people on their deathbed say to or towards people on their deathbed used to say. Because I don't foresee myself or any of you saying in your twilight years, I really wish I wouldn't have fought so hard for something I believed so much in. I just don't see that coming. I totally see it from the paint factory, right? I don't see it when you chose your passion that you feel most aligned with, where you want to be of some use. I don't see that statement on the horizon. For me, the thing that I believe I'm fighting for is freedom for everybody from dependence on the medical industrialized complex. From the pharmacy, from the surgery, right? Instead, a belief in a utilization of one's own physical resilience, right? The belief that changing the narrative and educating the public that if they train and fuel well, and they don't have a bad accident, that you can maximize and enjoy an incredible health span. And unfortunately, the narrative in this country is solely the opposite. The amount of people who are unbelievably dependent on a ridiculous amount of prescriptions, that are so quick to surgery, that leave anything healthy once they're injured, that we have so much to fight against. But I believe in this fight. And I don't believe that when I'm 80, I'm gonna say I wish I would have fought it less. I don't believe that. The principle runs too deep. REGRET CAN ALSO COME FROM UNDERWORKING Instead, and to close off the episode, a bit of real talk perhaps, I think that our regret risk in this generation, now that that shift where choice is kind of the driver of career has been made, the risk more lies in the following items. I feel like I never made a difference. I feel like I didn't fulfill my potential. I didn't go hard enough. I never found my limits. I don't know what I was capable of doing in the good fight. I never generated sufficient resources to be able to support myself and others. I think this is probably the list of regrets that is more common and they come from underworking, not overworking when you've chosen something that you believe in. And many of us get to make that choice. So my message to you on this Leadership Thursday is first of all, make sure you're doing that if you're able to. I do not mean to put anybody in a bad mental spot if they're like, dude, I'd love to, but my cards don't allow it. My situation, maybe right now and future, totally respect that. Do what you have to do. There's so much honor in that. If you get to choose, if those are your cards, choose something that you believe in and go all in. If you are a part of a team that achieves something that you believe to be deeply meaningful, you are not going to look back and wish you spent more time on yourself on vacation. That isn't how it's gonna shake out. You're gonna look back and say, I'm so glad that I was of some use. I'm so glad that I figured out the maximum that I was able to contribute in an area that I believe needed my efforts. That isn't something you regret. That is something you celebrate. It's time to push back against the narrative. Things have changed. Let's acknowledge it and let's stop scaring people into not working enough to find their potential because of things being different 30, 40, 50, 60 years ago. Give it some thought. Thanks for being here on leadership Thursday. We've got a million courses coming up. It's our busiest time of year. I think this weekend alone, we have 12 to 15 live courses. Make sure you jump on ptonice.com and check out that schedule. Get those skills, get out there and help some people y'all. Cheers. 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.  

In this podcast, the hosts challenge traditional ideas of discharging patients in physical therapy, emphasizing the importance of setting patients up for long-term fitness and lifestyle changes. They discuss the benefits of improving fitness levels, gradually introducing new members to CrossFit movements, building trust with older adults, and integrating fitness into physical therapy. They also stress the importance of social support and resources in making suitable fitness recommendations.

Learn about the importance of thorough palpation for differential diagnosis in the upper and lower extremity. Discover techniques for efficient palpation and identifying symptoms in different areas of the body. Understand how palpation can be used to differentiate shoulder and hip pain. Explore the role of palpation in identifying muscle tissue issues and the effects of prolonged sitting on the body.

Dr. Rachel Moore discusses bracing and engaging in conversations with fitness professionals. Topics include the disconnect between PTs and fitness professionals, key components of the brace, connection to the pelvic floor, proper use of weightlifting belt, and upcoming courses and newsletter updates.

The podcast discusses the importance of developing a healthy mindset around longer runs for athletes, including progressing gradually, running intentionally slow, and using them to practice for race day. It also explores the misconceptions and limitations of relying solely on long runs for training and offers tips for effective long run training.

The podcast discusses the financial aspects of the healthcare industry, navigating the complicated healthcare system, competing with chain clinics, and sustainable payment methods for physical therapy practices.

Dr. Christina Prevett, PT on ICE Daily Show Modern Management of the Older Adult division leader, discusses how to take the first step to change your Geri practice. She explores the challenges of implementing exercise interventions for older adults and suggests starting with one small change and gradually leveling up. She emphasizes the importance of addressing mindset and cultural barriers and provides tips for improving patient practice and workout intensity.

Dr. Paul Killoren, Dry Needling division leader, discusses how to market dry needling. Topics include designing an effective webpage with visually appealing images, addressing patient experiences to differentiate their approach, marketing the benefits of dry needling, and updating the look and feel of marketing materials.

Dr. Alexis Morgan // #ICEPelvic // www.ptonice.com  In today's episode of the PT on ICE Daily Show, #ICEPelvic division leader Alexis Morgan discusses the essential, yet often overlooked as aspect of early postoperative care. Alexis explores the wide range of concerns and adjustments individuals face postoperatively beyond the usual need for return to exercise. From emotional and mental health needs to navigating the logistics of daily life, we share valuable insights on how to care for individuals early postoperatively. Save this podcast and share it with your communities to educate them, and let them know what an early postop visit with you might would look like too! 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 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 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. In today's episode of the PT on ICE Daily Show, #ICEPelvic division leader Alexis Morgan discusses the essential, yet often overlooked as aspect of early postoperative care. Alexis explores the wide range of concerns and adjustments individuals face postoperatively beyond the usual need for return to exercise. From emotional and mental health needs to navigating the logistics of daily life, we share valuable insights on how to care for individuals early postoperatively. Save this podcast and share it with your communities to educate them, and let them know what an early postop visit with you might would look like too! 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 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 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. ALEXIS MORGAN Good morning, YouTube. Get Instagram going here. Good morning. Welcome to the PT on Ice Daily Show. Happy Monday. My name is Dr. Alexis Morgan, and I am one of the faculty with Ice Pelvic. In our pelvic division, we enjoy talking about all things around exercise. And, you know, if you are part of ICE, you know that and understand that. But sometimes our reputation scares people. It might scare our community like, oh, that's the exercise person. They're definitely going to make me exercise immediately. Today's topic is surrounding non-exercise topics for that early post-op care. non-exercise topics for the early post-op care. This is incredibly important, maybe because of the reputation that you have in your community, which if you have that, great, so do I. Awesome reputation to have. However, we need our potential patients, we need our clients, we need them to understand a lot of the things that we can do early post-operatively that don't necessarily involve exercise. And that's not just to get them in the door, but that's also because there's a huge role that we play in early post-op management. Now I'm discussing this with the lens of early post-op post C-section or post-op post hysterectomy or any of these post hernia surgery, any kind of core and or pelvic floor, pelvis type of surgery. That's the lens that I'm going to be discussing this in. However, I will say this is going to be in many of these cases pertaining to really post-op, any surgeries. And we've had a couple of great podcasts on this topic. And Lindsey Hughey has one that comes right to mind on things that we can do to educate to reduce inflammation postoperatively. But I'm going to add a couple other things to that list. So let's go ahead and jump right into those. ASSESSING VITAL SIGNS So number one, we need to be assessing vital signs. This is incredibly important in the postpartum period as maternal death rates are actually increasing in America. And for black women, maternal death rates are three times the rate as white women. Many of these are because of some type of cardiovascular event. We have got to check blood pressures. And in many cases, we as the conservative care providers, those physical therapists or rehab providers, we're some of the only ones that are checking postpartum. Or we might be able to catch something very soon before they might have a six or eight or 12 week follow-up postpartum. we've got to be checking their vital signs and assessing and making certain calls when necessary. That is absolutely important and definitely not exercise related at all. We can get them in and get their blood pressures checked. OWNING SCAR MANAGEMENT Additionally, we, we assess sutures or incision sites or whatever whether that was an abdominoplasty where they have an incision from ASIS to ASIS, whether that is a C-section incision, a little bit smaller, more midline, or that might be smaller little incisions all throughout the belly from some type of laparoscopic surgery. Whatever the case, We, as their rehab providers, assess that incision. We're gonna look for signs of infection and we're also educating about those signs of infection. We're assessing to see how the patient feels about it. Maybe we need to set some expectations surrounding what the C-section scar or what any of these scars are going to look like in a month and in six months. And with that, we can go ahead and begin some scar mobilizations. Now, very early postpartum, we're still in the proliferation phase, inflammation, then proliferation, and then maturation. We're still in that proliferation phase, so we're not gonna be doing scar mobilization on the actual scar, but we can come inches above and below and surrounding. We can teach them how to pull on their skin and press on their skin well away from the scar to go ahead and begin that desensitization. That is incredibly valuable. And just going ahead and painting the picture of what that scar rehab is going to look like over the next three to four months. Many individuals have a lot of fear and concerns surrounding the scar. And we are the best people to be giving them home exercise program, these interventions and helping them understand what it's going to look like. We know we're the rehab providers that have seen this all along the way in several other of our patients. So we can help them understand what to expect and If there's concerns where we need to refer to a mental health provider, then we're absolutely going to do that. That is completely within our realm to assess that and to refer out. And what a great opportunity to help someone. Body image is rather difficult. It always has been, but with social media and the way the world that we live in right now, It is incredibly difficult. And so we need a lot of times mental health providers to help us navigate that. So first we talked about vital signs. Now talking about sutures, we can absolutely discuss fueling. That's the podcast I mentioned with Lindsay Huey, so I won't jump into that necessarily. ASSESSING DAILY FUNCTION But next is ADLs. I was just looking through my messages, some screenshots that I've saved from various, um, various people who have messaged me about, um, pelvic floor related topics. And what I saw was this message from someone who said, I just went to my, uh, follow-up and they told me not to lift any weight. And the person asked, can I lift my baby? And they said, no. Now, obviously this is hopefully a one-off. Hopefully that word is not being said. And who actually, I don't know if the doctor actually said that, but the point is, is that this individual did think that that's what the doctor said. We are here to help them understand how can they be safe? How can they hold their baby? How can they get out of bed? How can they bend over and get the clothes out of the dryer, out of the washer? We can help them navigate these things. This is a great opportunity for occupational therapists as well. We can lean into their expertise here. Helping individuals with these ADLs can be really valuable for these individuals and can help them feel more confident in their body in that early postpartum period. Sometimes they just need to share their story. I think a lot of times we as rehab providers really feel this urge to do, do, do, put hands on, give home exercise program. I need you to do all three of these. We feel like so rushed in order to provide and sometimes The best thing that we can provide is a listening ear, is someone to be someone who can just ask questions about their surgery, about how they felt, about how they felt going into that and how they felt coming out of it. That can be incredibly helpful. ASSESSING READINESS TO EXERCISE While we're talking about non-exercise plans, I said that we wouldn't be doing exercise, but I didn't say that we wouldn't be talking about it. So when we have someone early postpartum, they might be an exerciser and they might be saying, oh, I'm not ready for exercise just yet. Well, that's okay. Let's talk about what does exercise mean to you? What does readiness look like to you? What do you want and what are your timeline expectations? And do they match up with what we have seen or what we expect? Having a conversation about an exercise plan and exercise expectations can be incredibly helpful. Some people may not understand that they can go ahead and start to move now. and they think exercise is any type of movement, and we can kind of break that down. We can discuss different exercises that individuals can do or that this person in front of us can do in this early time, like walking or some basic hip exercises or arm exercises. A lot of times there's several restrictions surrounding surgeries. But just because there's restrictions doesn't mean that there has to be zero exercise. So we can discuss that plan and kind of help them understand what that overarching picture of exercise and health looks like. I already mentioned one referral, but there are several other referrals that we can also make. So in the postpartum realm, referring back to their provider, their OB or their midwife. We can refer to a lactation consultant, to mental health providers. Postpartum doulas are another great referral source, particularly for people who are postpartum and maybe don't have a lot of family nearby. There are so many ways in which we can help people and We don't hold the keys to everything. I can't help with mental health. I can listen, but I don't have all of the tools, but I can absolutely refer to somebody who does. And together we can work to get this person in front of us feeling really good. SUMMARY So vital signs, checking the sutures or those incision sites, discussing fueling, helping them with their activities of daily living, their ADLs, listening to them, listening to their story, figuring out an exercise plan and referring out. The last thing I'll just mention here with pelvic floor and particularly with postpartum, we're gonna discuss with them expectations surrounding those. That's a whole nother podcast for another day, but discussing the expectations surrounding bleeding postpartum, leaking heaviness and pain and giving them what to listen to when we say, listen to your body, giving them a key to understanding what that exactly means. That way, once again, they can be successful. So that's just a little sneak peek into a whole lot of what you're going to learn if you take our online level one course. Our next cohort for our online level one starts March 5 so upcoming in one month at the beginning of March. It is going to sell out, just like this current cohort did so if you're on the fence about it, I recommend going ahead and purchasing that ticket because. If you wait too long, you're not going to get a seat. And we are very strict on keeping our student to faculty ratio at an appropriate level. That way you get your questions answered and you get the care that you need as you're learning from us in the course. So sign up for that. And we also have our first online level two course coming up at the very end of April. And so you're not going to miss that. Once again, that is definitely going to sell out. We are still months away from that, but only a few few seats remain for that. We're going to shut that one down pretty soon. So if you're on the fence about the online level to go ahead and sign up for that one. We are all over the place in twenty twenty four. Our next upcoming cohorts. for our live course. We're going to be in California, North Dakota, South Carolina, and Colorado. Those are our upcoming next courses, all in March and April. So be sure to check us out on the road. And remember, when you do all three of these courses, you are eligible for the ICE certification certified in pelvic. We are here to change the game when it comes to pelvic floor health and pelvic floor rehab. And we need more of you. So please consider hopping on the train, coming to our courses. We know you're going to have a great time. Thanks for being here this morning and listening with me. Have a great rest of your day and we'll catch 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.