While in the Hamptons, my main man Cody Benz started developing some neck trouble.
We thought it might be helpful for y’all to see what I would do to help a cat like him.
Here you will see me go through an entire treatment session with Cody, while I do my best to explain every decision I make. A major kudos to Daddy-o Pops Bill Hartman for asking some great questions throughout the treatment.
Instead of the typical transcript I provide for these longer videos, I decided to write this up similarly to my neck pain with sitting case study format. I reflected on this case while editing the video, so you’ll see some added thoughts I had while you read through. I would recommend watching the video and reading the case study to get the most out of the material.
Every week, my newsletter subscribers get links to some of the goodies that I’ve come across on the internets.
Here were the goodies that my peeps got their learn on from this past July.
If you want to get a copy of my weekend learning goodies every Friday, fill out the form below. That way you can brag to all your friends about the cool things you’ve learned over the weekend.
Biggest Lesson of the Month
Maximize proximal before spending time distal. I’ve just seen too many patients where we applied some type of axial intervention, which led to profound changes distally. Position governs all. Thank you for making me realize this daddy-o.
Quote of the Month
Only those who dare to fail greatly can ever achieve greatly. ~Robert Kennedy
My boy Scott Gray put together a rock solid post on diagnosing an ACL tear. I’ve been very big as of late on filling the differential diagnosis hole in my game, and this one was beyond helpful. I wish I had heard of the lever test last year when I had a guy pop his ACL in-game.
My buddy Doug Kechijian ever so succinctly puts this dated test to rest. There is so much more that goes into deciding squat depth than can be accurately accounted for with this test.
I’m still making my way through this beast. It’s a thesis, but the references and explanations of the science behind breathing, position, and recovery is outstanding. Not only that, but changing your recovery position has had a profound effect on improving my clients’ conditioning.
So proud of my guy Eric Oetter, who put this incredibly practical guide to load management together with the brilliant Tim Gabbett. EO is doing phenomenal things with the Grizzlies, and this provides a small insight into his process.
Short answer – It depends. I have a coworker who I discuss with the problems of this argument. I’m an avid meat eater because gainzzz, and it turns out that makes the difference. If you aren’t listening to Ronda Patrick by the way, you’re welcome.
Chris Kresser is a cat I’ve been really getting into as of late. I think there are a lot of cool things within functional medicine, and this guy is one of the most evidenced-based out there.
I think the gut microbiome is a vastly underappreciated area to intervene on. But how do you know if you have a problem? CK tells you how to find out.
This Rhonda Patrick joint talks about all the wonderful things lactate does for us. This molecule always gets a bad rap, but did you know in brain injuries (concussions, TBIs, etc), it’s one of the few substrates that is capable of providing our brain fuel? This was a very fascinating hour in which I learned a great deal.
What if I told you that there was a way you could keep eating what you are eating yet still lose fat and gain muscle. Would you do it?
If so, then this is your study. By simply restricting the eating window to 9-12 hours in mice, and having them eat earlier in their day, these bad boys lost some major weight. He did a similar study in humans as well. He goes into detail about this and more. Both the paper and the podcast are quite interesting
I’ve been on a little Rhonda Patrick (#bae) kick as of late. In this interview, Dan Pardi talks about all things sleep, circadian rhythms, and more. If you can maximize sleep duration, intensity, and timing, you are winning at life. Never thought of sleep described in this manner.
An oldie, but a goodie. I’m taking my time with this one because it’s a big book and filled with so many practical applications. This book inspired me to check my email, and respond, less frequently. He’s given me so many ideas on streamlining my life. You’ll love the tips he has for elimination and automation. Incredibly practical.
Given that I’m pretty green at being a PT mercenary, this website has been gold for me. If this doesn’t inspire you to consider travel PT, nothing will. The money is real, and it seriously feels like I’m on vacation all the time.
Me on the left by the time my student loans are paid off
I recently had to prepare for a salary negotiation, and just reading a few chapters from this book made the process go exceedingly better than I anticipated. Negotiating, like many things, is a skill. This book will teach you the fundamentals to a skill that will benefit so many aspects of your life.
As y’all probably know, I am a major hip hop head. Like, pretty much all that I listen to. I found this cat on Spotify while at the gym, and was blown away. Has fire lyrics over insane samples. Listen to the joint called “Moses” which features Twista and Bun B. Un…be…lievable
I’ve lately been trying to read something a bit less technical right before bed to help me fall asleep (which has been working well btw). First book I chose was this gem by the creator of XKCD, Randall Munroe. He basically goes through and answers ridiculous questions in the most scientific manner possible. It’s a brilliant combination of interesting and funny.
My favorite so far? “What would happen if you had a mole of moles?” #deep
Did you miss yesterday’s Movement Debrief? We had a lot of fun. The first time I went on facebook, twitter, and Instagram simultaneously.
This debrief was a bit different, as it didn’t involve as much reflection on my patient care, but more on the wonderful continuing education weekend I had.
I got to spend time with all my friends learning about a lot of different things. And it led to some great reflections.
Here’s what I talked about:
Why trial and error is important
Being outcome-focused
How triplanar movement impacts single plane movements
Just when I thought I was out, the clinic pulls me back in.
Though I’m glad to be back. There’s just a different vibe, different pace, and ever-constant variety of challenges that being in the clinic simply provides. This has been especially true working in a rural area. You see a much wider variety, which challenges you to broaden your skillset.
I’m amazed at how much working in the NBA has changed the way I approach the clinic.
Previously, I was all about getting people in and out of the door as quickly as possible; and with very few visits. I would cut them down to once a week or every other week damn-near immediately, and try to hit that three to five visit sweet spot.
This strategy no doubt worked, and people got better, but I had noticed I’d get repeat customers. Maybe it wasn’t the area that was initially hurting them, but they still were having trouble creep up. Or maybe it was the same pain, just taking much more activity to elicit the sensation.
It became clear that I was skipping steps to try and get my visit number low, when in reality I was doing a disservice to my patients. This was the equivalent of fast food PT—give them the protein, carbohydrates, and fats, forget about the vitamins and minerals.
If fast food PT fits your macros tho right?!?!
Was getting someone out the door in 3 visits for me or for them? The younger, big ass ego me, wanted to known as the guy who got people better faster than everyone else. Yet the pursuit became detrimental to the patient’s best interest. There were so many other ways I could impact a patient’s overall health that I simply sacrificed in place of speed.
I only got them to survive without pushing them to thrive.
I see a lot of individuals proudly proclaim how many visits it takes for them to get someone out of pain, but pain relief is only part of the equation. There are so many more qualities we can address before we consider a rehab program a success.
This stark realization has reconceptualized how I structure a weekly rehab program. I now emphasize all qualities necessary to return to whatever task the patient desires, and attempt to inspire them beyond those initial goals.
You want to know what my visit average is right now?
I stopped counting, and started treating.
Let’s look designing the rehab week to take your clients to the next level.
Not only has a lack of sleep been linked to many big bad diseases, it also contributes to poor performance.
Behavior change through education and persuasion is hard enough as is. We are all resistant to change, namely because our current habits and routines require Herculean willpower efforts to break. This problem is especially true in non-conducive environments.
It’s hard to eat healthy when your family cooks fried foods and orders pizza for dinner every night.
It is these situations where we just have to make the most with what we have, and that’s exactly what I spoke about on one of my best friend’s podcasts, Doug Kechijian.
Before we go into the content, let me tell you a bit about Douglas, my younger-older brother.
So young. So youthful. So of poor quality of a photo. Doug is 3 people right of me
I was the first person who arrived in town, and it was up to me to take care of the rental car.
We had five bros to get to the class, so I needed to find something cozy that could fit everyone and their luggage to and from the class and Phoenix airport.
So I’m looking at some midsize SUVs, a couple sedans, trying to find the right car that I could fit everyone in.
Then I saw this:
So…fast…now my realistic dream car.
Doug and I had never met before, and he was the first person I had to pick up. He asked “what will you be driving?”
I said “you’ll know.”
So there I am, picking Douglas up in this Dodge Challenger flarin’, hip hop blarin’, shade-wearin’, and straight up stuntin’ in that AZ heat. The car was a great ice breaker towards realizing how likeminded we both were.
All the other guys we had to pick up were flying into town every couple hours. For the hell of it, we made the 20 minute drive back and forth to the airport in that Dodge Challenger. We ended in clown car fashion, but it was totally worth it…Well, for me at least. I got to drive that beast!
It was in those hours, that weekend, that coziness, that these two cats who didn’t know each other developed a long lasting friendship. I am fortunate to say that about every single one of those guys in that picture.
Doug is simply one of the most intelligent, grittiest, interesting, and eloquent individuals I know. He is without a doubt a thought leader in the fields of physical therapy and performance. Each time we hop on our 2+ hour call to catch up, I always become a better clinician, coach, and person. He is a wealth of information, served our country with distinction, and a great human being. I am honored to call him my friend, and you guys should know who he is.
He’s also a really good agent, as he’s gotten me two of my most recent jobs!
So please, check out his site, follow his killer twitter, watch him demonstrate exercises shirtless on Instagram, see him in NYC, and do all you can to learn from this guy.
On a side note, he and his two partners, Trevor Rappa (aka my son)and Greg Spatz (aka my step-son), put on seminars periodically throughout the year.
Why am I pointing this one out? Because I’m going to be there. I want to learn all that I can from these guys. As should you.
So if you are a reader of mine, go to this seminar and we can get together for some grub and discussion. I plan on being around the Bay Area for a little while (there’s National Parks to be hiked after all), so please attend and support my dear friends.
Improving Sleep the Easy Way
I was recently featured on Doug’s podcast where we discussed my sleep initiative that I executed when I was with the Iowa Energy of the NBA D-League.
While the article covers logistics, this podcast details the why’s, how’s, when’s, etc.
