#PTonICE Podcast

Dr. April Dominick // #ICEPelvic // www.ptonice.com In today's episode of the PT on ICE Daily Show, #ICEPelvic faculty member April Dominick shares some insights and a "big win" from a coffee marketing meetup with a physician. She cites 5 clinical pearls for how to approach challenging the status quo of practice patterns with the providers in your community. 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 Good morning, everyone. This is Dr. April Dominick. I am on faculty with the Ice Pelvic Division. And today I wanted to discuss a recent marketing win that I had with a physician and some insights regarding how to challenge the status quo of practice patterns within providers in your community. One concern that we often get with our ICE courses and especially in the pelvic division is someone will say, hey, I love all of this incredible research that you all are sharing that is completely different from the way that I practice and I'm so stoked and I'm so behind it. But how do I recommend or how do you recommend that I bring this back to a community of providers who are pretty steadfast in their practice patterns? So today I'll share that recent interaction. And again, it was a marketing meetup with a physician and I want to share how it went from an invite for a latte to an invite for a lecture that I could give And all of that happened in just under 35 minutes. So I met with an OB who I have a pretty solid referral relationship with. She refers folks to me, I refer folks to her, and we were just catching up over some mutual patients that we had. And the conversation ended up turning towards how she counsels patients in the pregnant and postpartum space in regards to exercise. And she absolutely encourages people to continue moving, keep exercising, working out. But she says, you know, I caution them against doing planks and I don't really support twisting and turning because I don't want to make that diastasis recti worsen or that thinning of the linea alba. And she also says that she cautions individuals with any sort of impact because she doesn't want to further any sort of urinary incontinence. In my head, I was like, ooh, gosh, there's so much research that has come out, especially in the past six to 10 years, that doesn't support that line of thinking. But how do I share that with her without, you know, stepping on her toes and interrupting this beautiful relationship that I've developed with her? So I asked, I said, would you mind if I shared some updated evidence that we have regarding all of those topics? And she was totally game. She was like, fire away. Yes. So I shared the benefits and the protective mechanisms that we know about as far as core strengthening during pregnancy and early postpartum. I relayed to her the reality of the situation regarding diastasis recti is we don't even really have a consensus in the literature for defining it. And I also quoted some studies that we also talk about in our live courses and our online courses about when it comes to someone who is one year postpartum, they are likely still, some of them still have a diastasis recti and that those with a persistent diastasis recti tend to have a weaker rectus and oblique strength score compared to those without a DRA about a year postpartum. I also anecdotally, I mean, I had to squeeze this in somehow, but I anecdotally shared that since I started loading the core more during pregnancy and early postpartum, that some of our mutual clients, I did some name drops, have actually had relatively quicker recoveries on the back end, on the PT side. And they've returned to their functional activities seemingly with more ease. And that was, of course, all things considered and just an anecdote, but it's something that a trend that I've noticed. And that's all for folks who have prioritize course strength training as opposed to those who have not or those who continued some sort of resistance training of some sort. We also talked about other topics and I threw in that we have a lot of evidence regarding the benefits of resistance training and lifting heavy during pregnancy and some preliminary evidence that says hey, exercise and heavy strength training may support the role of lowering some pregnancy complications, including gestational diabetes, gestational hypertension, and even some perinatal mood disorders. And then of course, I let her know, you know what, I am there to help support someone in their endurance training, their impact training, Um, and I help address that pelvic floor dysfunction. So I actually will come alongside someone, um, with those goals. And if there is any sort of pelvic floor dysfunction or urinary leakage, um, I got them. And, and that's not something that I discourage. Her mind was blown. Like she was glued to me as I was just rattling off all of this new information to her that differed from her current practice patterns and likely what she had been trained under when she went to school or in the last continuing education class that she went to. Or maybe she just hasn't really been to any of this because that's not necessarily her expertise. So she was just mind blown and she was so excited to learn this new information. And I said, you know what, this line of practice that I just shared with you, all of these recent updates and literature, this is more of a recent shift even for me. When I first started practicing in pelvic health, up until three to four years ago, I had many of the same practice patterns that you just shared with me. And in fact, many PTs, many other pelvic PTs are still currently practicing with those similar philosophies because that's how we were trained. And not everyone is caught up in respect to the latest evidence. So we talked about different concerns also that we hear in our clinic rooms. And that was fascinating, a whole nother podcast episode, but it was just really fascinating to hear that some of the concerns that her clients have, that our clients have, what they tell her in the clinic room is very different from what the conversations I have. And of course I shared with her, you know, a lot of the folks who are pregnant and postpartum, They have so much fear on board regarding getting a diastasis recti during pregnancy. By the way, it's 100% normal. And how they often pay for generic programs to get flat abs from Instagram influencers and they don't work and then they're frustrated. Or they share with me how they're just terrified about getting a perineal tear during delivery. or they're just determined not to have their organs fall on the ground after pregnancy. And it was so interesting because she, she was like, April, that is, those are not the main concerns in my sessions. And she was like, this is so informative to hear what's happening over there. She also doesn't have Instagram. So I feel like that may influence what it is that she sees and hears. But again, we were talking about in our clinic spaces. So I also got curious because I had some questions that were more on topics about her expertise, like perimenopause, menopause, and hormone replacement therapy, which all of those topics are being discussed way more in the pelvic PT space now. So at the end of the conversation, she thanked me so much for sharing the recent literature. She said, I am so much more confident now promoting whole body strength, including the core, like I feel comfortable because of what you shared with me, promoting people doing planks and promoting impact exercise throughout pregnancy and postpartum. She wanted those articles emailed to her immediately. And the most surprising and probably the best part of this entire meetup was that she asked if I would like to give a presentation at Grand Rounds of the do's and don'ts of exercise during pregnancy and postpartum. She was like, my colleagues would 100% benefit from hearing what you have to say. It'll be a tough crowd because she said many of her fellow nurses and physicians assistants and doctors practice from what they learned, uh, 20 to 30 years ago and are even way further behind than how she practices. She's like, some of them are still promoting bed rest. Um, even when the client doesn't meet that criteria. And she said that she often will come behind providers as she's rounding up the hospital and say to the clients, no, I want you to get up and move. Moving is good, exercise is good. Because I guess some of her other colleagues have said, no, no, no, just stay in the bed, stay in the bed, that's gonna be better for recovery. So I was of course ecstatic when she asked me to do a Grand Rounds lecture. I told her, you know what, it would even be very helpful from my perspective if clients heard about the benefits of continuing resistance training and core work and impact exercise from the medical community because Clients have so much respect for the medical community. So if they are hearing about it first from them and then they get to see me later, if that's the order that happens, even better that we are reinforcing that strength is queen and that can help knock down a lot of those fear-based messaging that our clients get. So, In a matter of 30 minutes, I went from coffee grounds to grand rounds. I want to identify just five things or themes that I came up with from that interaction that may help you cultivate a relationship with a provider, whether it's an OB, an orthopedic surgeon, or a chiropractor, massage therapist, whatever. Use these when you are going to market. LEVERAGE THE LITERATURE Number one, leverage the literature. and thoughtfully ask if it's okay for you to share that recent literature has overturned some of those old tiny beliefs. So reference some of the amazing evidence-based pearls that you've gotten from your ICE courses or from some of our posts. It's all about being respectful for that delivery in the question. So I'd recommend that you just be honest and say, would it be okay if I shared some of the recent literature with you that I have found incredibly helpful for my practice in bettering client outcomes? VALIDATE THE OTHER PERSON Number two, validate them. Share that it wasn't long ago that you were practicing in a different way that maybe didn't align with some of the recent clinical practice guidelines. Sometimes the oldest techniques don't necessarily stand the test of time and they may not be the most effective. SHARE CLINICAL OUTCOMES Number three, share some stellar clinical outcomes. Use wins from mutual patients if that's an already established referral source. ASK FOR ADVICE Number four, ask them for advice. When it comes to a topic that is in their expertise that you may be curious about, or maybe you have an uptick in this particular diagnosis on your caseload. There is nothing that people love more than talking about themselves. Exhibit A, just kidding. Um, but they love talking about how they treat their philosophy. And when you ask someone for insight that shows, you know what, that shows that you're curious and you're wanting to learn from them. So it becomes more of a two way street. LEAN INTO YOUR PERSONALITY & PASSION And then finally, number five, lean into your unique personality and passion. When people get a sense of how incredibly passionate you are about changing lives and how you practice being about it day in and day out, they listen. Think about the first time you tuned into a PTA on Ice podcast episode with Jeff Moore or Christina Prevett blasting their truths from behind the mic. how you can feel their excitement through your speaker as they rap about getting that PT version 2.0 going, about how we need to remove barriers to exercise in the older adult, the pregnant and postpartum space. So lean into your personality, whether it's loud and proud or quiet confidence, and let that drive your passion behind changing the status quo in your community. I hope you found this marketing one of mine and those insights helpful for your next marketing meeting. Remember, leverage recent literature, validate the provider and how you may have just recently shifted to using these more evidence-based interventions and strategies, share recent client wins and trends, get curious about their expertise, and then lean into your personality and let that elevate your passion for providing Fitness Forward, evidence-informed care in the PT space. SUMMARY If you're feeling like you need to brush up on some of the latest research and treatment strategies in regards to fitness, guidelines, and any sort of pelvic health issue, join us in our Ice Pelvic Courses. We have some live courses coming to you. Alexis and Rachel will be in Newark, California. the first weekend of March, and then Alexis and I will be in Bismarck, North Dakota the second weekend of March. There's still time to sign up for those. And then from an online perspective, our next level one cohort starts March 5th, and we only have a few seats away from being sold out for that cohort. So hop on in. Thank you so much for joining and remember to bring that Be About It attitude not just to your workouts but to your marketing meetings and coffee meetups as well. Cheers y'all! 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.

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.