Improving movement options is legit, but at what cost?
We know that this breathing stuff works, but are there drawbacks to this approach? Can we really make the changes “stick?”
These are a few of the many problems that Dr. Tim Richardt and I sift through, in a podcast where the script is flipped and Tim interviews me.
In this podcast, you’ll learn:
- How I structure my own training
- What’s better, time management or energy management?
- Forget following your passion, focus on this instead
- What my biggest failure was and what it taught me?
- The dichotomy of the type A personality
- Movement behaviors: How do we get them to “stick”
- The dark side of internal cueing
- The best way to communicate effectively to clients
- and more!
Is there a darkside to all this movement stuff? Is there a better way?
Look below to watch the interview, listen to the podcast, get the show notes, and read the modified transcripts.
and the audio version:
Learn more about Tim
Tim Richardt is a Doctor of Physical Therapy, Strength and Conditioning Coach, and Owner of Richardt Performance and Rehabilitation located in Denver, CO. He specializes in the treatment and preparation of humans that like to run, lift, or play in the mountains. He currently offers personal training, physical therapy, and professional mentorship services.
More Train, Less Pain Podcast – Tim’s podcast that is specifically designed around engineering the adaptable athlete.
Here are links to things mentioned in the interview:
Elevate Sports Performance and Healthcare – Where ya boi works
Francis Hoare – An excellent coach who works with me at Elevate.
How to Fail at Almost Everything and Still Win Big by Scott Adams – One of my favorite books. This book taught me to emphasize systems over goals
Millionaire Fastlane by Mj DeMarco – This book completely flipped all that I know about business upside down.
Unscripted by MJ DeMarco – This book will keep you pushing forward in all things business
Extreme Ownership by Jocko Willink – A book that helped me take ownership of all my own problems.
The Obstacle is the Way by Ryan Holiday – If you are going through a tough time, this read is essential.
The Ego is the Enemy by Ryan Holiday – This book will help squash any ego issues you may have
The Subtle Art of Not Giving A Fuck – Basically modern Buddhism. A must-read
Everything is Fucked: A Book About Hope – Why hope is BS and how to start a religion. It’s an awesome book.
Aline Thompson – One of the best PTs in the Denver area.
Georgie Fear – My incredible nutrition coach. A master at behavior change
Lorimer Moseley – One of the best pain researchers in existence.
David Grey – An excellent physio
Gary Ward – All things foot, he’s the guy
Seth Oberst – One of the best at all things trauma-related from a movement perspective. I reviewed his course here.
Michelle Boland – Coach Bo. One of the best coaches in da game. I reviewed her course here.
Boo Schexnayder: Rehab Insights from Track and Field – This podcast made me appreciate intensity and its importance
How to Win Friends and Influence People by Dale Carnegie – The OG book on interacting with others.
The Truth Detector by Jack Schafer – An awesome read on elicitation and interaction with others.
Bill Hartman – Daddy-O Pops himself. My mentor.
How I structure training
Tim: So, my man, I thought we could start with your own training. And I’m wondering if you could describe the last workout that you personally did?
Zac: Well, that would have been yesterday. I train mostly at night after work. Yesterday, it was chin-up day.
I start with vision exercises because I did some vision therapy, so I’m just trying to maintain the visual skills that I currently struggle with, which is the ability to diverge.
So, divergence is the eyes moving apart. You basically stretch them out, which is kind of like external rotation of the eyes, if you can think about that way, which is expansion. And guess who doesn’t have that? Ya boy, same thing with everyone else. So, I do some moves to work on divergence, but then focusing within the divergence, which is accommodation. I spent a few minutes doing that.
And then my warmup, I kind of do the same thing. I just roll around on the ground for a while, do just a few moves to – yes, I just literally – they were finishing class at Elevate and Francis is like, “Don’t worry about the Ninja who works here in the background.” Which was funny. So, just warm-up and then…
Tim: Just some spinning flying kicks?
Zac: Yes. Something like that.
Tim: Yes. Like three sets of five…?
Tim: Yes, of course. I saw those in your office.
Tim: I was going to ask about that.
Zac: Once I do that, then I do my main move for the day, which yesterday involved post-activation potentiation combo. So, I’ll do med ball throws up against the wall, rotational-style, and then chin-ups with some weight. I did these in the 3-6 rep range until I can’t do that anymore. And then I ended up doing a trap bar squat and overhead press.
And then I usually do like a circuit of some – like something single leg. I did like a single-leg squat off a box. I do pushups. I do one-arm dumbbell row. And then, like the body saw. I did a circuit of that with just, you know, whatever reps I need.
And then sometimes I’ll follow with conditioning. But I did my favorite conditioning yesterday, which is kicking my man Francis ass and spike ball. Boom! You heard it internet. We usually play spike ball once a week and we have some good competition. We both have gotten pretty good.
We did this thing where we were just playing Spikeball one on one for months because we both sucked.
Zac: We didn’t tell anyone.
Tim: One on one spike ball?
Zac: Yes. It’s weird, but it’s fun. And so, Francis was killing me and I can’t have that happen because I hate losing in all things. So, I’m like consuming YouTube videos and figuring out how to serve. And so, now I can serve with both hands…
Tim: Walking around with the spike balk all the time and go for it?
Zac: Yes. And so, now we have some great games and we’re just like hitting it way good. And we finally played two on two, not together, but it was way more competitive than we ever did. So, that was the skill that I learned. And that was my training session.
Tim: How do you think kind of in the macro about structuring your own training? Like, do you have short, medium long-term training goals, and you kind of period eyes to accomplish those? Or are you more like a fly by the seat of your pants kind of guy?
Zac: I have my main moves that I alternate between. So, what stays the same, and I got this, it’s the mass effect program from Daddy-o Pops himself, Bill Hartman, just with some slight modifications. It looks like this:
- Lift one: 4-6 reps
- Lift 2: 6-8 reps
- Lift3: 10-12
You do each of these until you fatigue out of those rep ranges. And then I just do, you know, two to three rounds of whatever else I feel like I need, which can be like eight to 12 reps. And if there’s a day I need to condition, I’ll do that.
If I want to do some extra arm farm, I do that. So, the three mains are there. I keep trying to get better at them. But the other stuff just varies depending on what I’m feeling. Because my main goal training-wise is just to look good naked.
Zac: And maintain decent body comp.
Tim: No, more fat Zac?
Zac: Yes. Fat Zac is done.
Tim: Fat Zac’s not coming back?
Zac: He’s done.
Tim: That guy was fun though.
Zac: He was fun. Yes. He had the beard. He is like a young Santa.
Tim: Couldn’t touch his toes.
Zac: Yes. Definitely couldn’t squat. I still can’t touch my toes, but I can squat now. So yes. And then like, you mentioned like periodization, I need to train enough that someone can take me seriously from a movement standpoint. It’s kind of like looking the part when you’re being a PT because I do think that that matters to some extent.
Zac: But right now, the highest priority is work, teaching, all that stuff, learning the craft. And so, that’s always going to be the A1 for right now.
Tim: The A1 of life. Yes. A2 is fitness.
Time management vs energy management
Tim: You gifted me a Scott Adams book about five or six months ago. In it, he talks a lot about this myth of time management and argues that time isn’t necessarily the resource that we should be seeking to manage, but it’s instead energy. And that in managing your own energy and taking on projects that seem to give you energy rather than drain them or tackling endeavors that seem to increase energy, you can get a lot more done versus just trying to very efficiently kind of micromanage your own time.
So, you’re one of the most kind of efficient, effective, prolific people that I personally know within our field. What do you think about this energy management concept? Is that something that kind of lets you do the amount of work that you do?
Zac: It’s very easy to waste time on frivolous things and I try to do my best to minimize that now. But I think because I have a little bit more freedom to do that now. I can, I think, for example, a couple of years ago I had the shackles of student loans, so it’s like, I’ll take on anything I can do to try to manage that. But I do think about that when I’m thinking about things that don’t bring joy into my life, like social media, for example.
Zac: I try to stay off that as much as humanly possible. Because it does take energy, even answering texts. Like I’m horrendous about getting back to people via text message or phone calls because I eliminated notifications on that. Because even that takes energy out.
Zac: Even being around certain people who suck the life out of you…
Tim: Exactly the black hole type of thing?
But at the same time, I do think time management to some extent is important as well because, sometimes you might have to do things that are energy-draining, but they help move the needle forward. Does he talk about following your passion as well and how that’s BS?
Tim: And I’ve probably had that conversation with like 10 people over the past week that like passion is fleeting. It’s, you know, rocket fuel, but it’s not actually going to sustain you over the longer. It opposes a lot of advice that you conventionally hear.
Zac: Yes. Well, what you have to do and there’s another good guy you should read it. I might have an extra book. I’ll give it to you. MJ DeMarco. He wrote “The Millionaire Fast Lane” and “Unscripted.” He talks about that as well in the sense that you don’t want to do things that you’re passionate about.
You want to do things that are going to have a positive impact on the world and change things forever. And then if you do that and you make enough money from that, you eventually will become passionate about it becauseyou’re making an impact.
Zac: I love video games, but I’m not going to be making money, playing video games unless I started…
Tim: I was thinking about Twitch and Onlyfans. And I’m like, is there a way to combine those concepts and maybe have people pay you to watch you play video games in a reduced amount of clothing?
Zac: Haha right? But even with that, sure, you can make money, but Twitch is not going to change the world.
Zac: And I want to try to make the little world that I’m in, that we’re in, a better place in that sense. And that’s really the crux of what I do. That’s why I try to take complex things and simplify them so most people can carry it out.
I have a lot of good friends who are really smart, but they might not be able to devote the time and energy to diving deep into topics because maybe they got kids to worry about and all this stuff and well, they still patients to take care of.
Zac: And so, if I can help that person get better a little bit faster, then I think we all win.
Tim: I mean, and is doing that something that you find gives you more energy than it drains or drains kind of a minimal amount of energy?
Zac: Yes, absolutely. I could teach, talk all the time. I love that. Even doing these podcasts. It’s so much fun and then it’s just time flies by. Because then it’s also, you’re just interacting with people and…
Tim: Also real-life people.
Zac: I know. Right?
The failure that changed everything
Tim: That’s useful. I think along the same lines of that book, it’s in the title that he’s amassed a massive amount of failures and yet still is an extraordinary success. Thinking about kind of your own life professionally in the past five or 10 years, what are some of your favorite failures?
Zac: Professional basketball.
The thing that I had going into that was getting to pro basketball kind of a big deal. And I probably let that get to my head a little bit. I think I had a little bit of a Dunning-Kruger effect kicking in. Even though like I still would say back then, I was a pretty good practitioner. I’m much better now. But I think I let that get the best of me that I was in that setting.
I can’t say that that’s why I was fired, but after that happened, it completely flipped everything.
I did a lot of soul searching during that time period. And there were four books that I read that just like changed everything.
Tim: I bet I know one of them.
Zac: Which one?
Tim: “Extreme Ownership.”
Zac: That was definitely one of them. That was one, “The Obstacles is the Way,” “Ego is the Enemy” both by Ryan Holiday and then “The Subtle Art of not Giving a Fuck.” by Mark Manson.
I read those four and that’s when I realized my behaviors, my issues were the problem. And I was able to do things to flip that and just be more humble, reacquire the beginner’s mindset, interact better with peers and people who I’m working with.
And it really made a big difference. And I’m grateful for that. I’m grateful that I was out of that situation. It pushed me towards more of what I really like, which is this. And the fact that now I have a bit more freedom flexibility than I did in the league, was huge. That’s probably the biggest failure that has flipped things for me.
Tim: Going back to something that we discussed, like removing things in your life that are not really serving you. The hard truth is those are people and probably people that you’ve known a really long time.
And you know, If you can’t kind of reflect back on your own life and make a decision about which people you’re spending time with, you’re liable to get trapped in a lot of, and trap is probably a strong word, but waste the resource of energy on relationships that aren’t getting you to where you want to go.
Zac: Is that something that you ever struggled with? When you knew you had to move on from a situation or a person?
Tim: Yes. The job I took right out of school being a director of rehab in rural Colorado.
That was so nice because it was lucrative. It was flexible. I think I could still do a lot of the things that I wanted to because it was a three-day workweek.
In a lot of ways, it was the perfect situation, but it didn’t have any upward trajectory to it. I started at the ceiling. I’m immensely grateful that I had that opportunity. And I think it changed me for the better, in many ways. But after my three years and change out there, I knew it was time to do something else. Something that had a little bit more of an avenue for growth.
Zac: Yes. It’s hard when you get comfortable like that because the chance of getting stagnant is significantly higher. And so, you always got to put yourself in slightly uncomfortable positions, I think, to really grow.
Tim: Yes. It’s a really interesting juxtaposition. I mean, that’s something I think about all the time that type A people, kind of people like you and I, a lot of what drives us is we’re not happy with the way things are. But if you let that mindset pervade everything, then you never really enjoy what you have.
So, it’s a really interesting tight rope to balance kind of, as physical therapists, as athletes, as human beings, how do we hold these two seemingly opposing ideas in our head simultaneously and not kind of fall apart?
Zac: Yes. That’s hard.
Zac: I definitely let that bleed into areas that it shouldn’t bleed into.
Tim: Yes. Some things in life are just fine and they’re okay the way they are. They don’t need to be optimized.
Zac: Yes. There are some things too that you got to just keep pushing.
Tim: Absolutely. I mean, that’s how people do great things. You’re not going to just get this great opportunity kind of plopped in your lab.
Zac: How do you find the balance? You probably are better than me.
Tim: I don’t know. I don’t think I have a really good answer. I was talking to a mutual friend that we have, Aline Thompson.
She was mentioning this friend that she has an incredibly high-powered tech broker of some type, makes boatloads of money.
But he’s a really, really good chef. And he says that the second he no longer has time to cook each day, that’s the line in the sand that he draws between. That means he’s striving too much. That means he’s packing so much into his day that he can’t just enjoy what he already has, which is quality time doing something good for himself, for his family, for his children.
That really hit home. I love to cook as well. I also like to play Frisbee with my dog, Molly. If I can’t take 10 or 15 minutes to do that like that’s another – like I just want that to be built into my day-to-day. And then if I can maintain these things and then continue to strive and see certain life, key performance indicators trending in the right direction, I am doing an okay job.
Zac: That’s something I probably struggle with because I’m thinking about like, as you were saying that I’m like, “That’s brilliant. Like everyone needs to find their cooking.” And I don’t know what mine is.
Tim: I think for a lot of people it’s working out.
Tim: Probably not in our industry, because I think we are the people that will probably sacrifice in order to train and train at very inconvenient times. But I think for 99% of the American population, that’s one of the early things to go.
Zac: Yes. That’s very reasonable. See, I can’t fathom not having that. It’s so automatic at this point that – there was one time where maybe I didn’t work out and I’m like, I’ll notice that one day if I had a plan to workout, I can’t do it. But I’ve never gotten to the point where I’ve worked so much that I’ve had to cut that out.
Tim: And you do, and it’s like a superpower.
But you go about the rest of your day supercharged, you know that you’ve done something that’s probably more difficult than 90% of the people that you’re going to interact with have completed that day. Especially for people like I’m a big morning trainer.
Tim: Yes. I’d love to train at like 6:00 AM or 7:00 AM. And that’s recent. That’s as I’ve gotten older, but in terms of the Scott Adams concept of adding energy to your life, it’s like, that is something that so acutely drains you of energy and yet so quickly fills you right back up.
Zac: Yes. It is interesting how that works. Isn’t it?
Can we get postural changes to stick?
Tim: You and I, both physical therapists, we commonly see people that present with particular movement behaviors or positions. And I think one of the most pervasive ideas in our industry is that there’s a bad posture or a bad position. Right? Like extension, anterior, pelvic tilt, rotation. What have you?
Zac: Oh sure.
Tim: There’s this idea that there are these bad postures and people have bad postures and well just swap it out for a good posture and they’re going to be good to go. Something you and I have talked about before is these postures positions, movement behaviors emerge in order to solve a particular problem? To manage gravity, to breathe, to better prepare you for a training stressor that you’ve experienced before.
So, I guess how do you think about replacing a less than ideal movement behavior or pattern with a better one, because that’s kind of what we do with these resets, with these drills to regain mobility? And how do you think about making that intervention like quote-unquote, “sticky” enough so that a person doesn’t revert back as quickly as possible?
Zac: I don’t think it’s replacing one for another. I think the key is giving more options. So, for example, if we go with like the forward head, I’m sitting at the chair for an extended period of time, you do that long enough, something might get cranky just because of tissue ischemia or whatever. At the same time, if you sit perched upright and have a good posture, and you hold that long enough, you could probably run into similar issues.
But if you can get into each of those and a bazillion more, well, then you’re never really overloading any specific areas. And I think it makes you more adept to surviving in several different environments. And I think really that’s the key and that’s like, what movement variability is all about is you need as many different ways to perform the task as possible even if you’re getting the same consistent output.
So, like if I did 10 squats and even though they looked exactly the same to the naked eye, if I have to remove that variability, there should be subtle differences with each one of those squats, but it’s when I don’t have those options available that problem ensue
Tim: In both coordinative and endpoint variability.
Zac: Exactly. I think that’s really where the money is. Now, how do we get that to stick? It’s basically, getting people into positions that they can’t normally get into or struggle maintaining into and then being able to demonstrate that at progressive intensities and complexities.
So, for example, you know, if we look at you and you know because we worked together for a minute. In the beginning, we started with some simple drills, some single leg positions, more supportive, really emphasized breathing. And look at where you’re ay when we worked together the other day. Now we’re giving you loaded-based strategies…
Tim: Kicking ass, taking in?
Zac: Yes, yes. Getting you a ridiculous pump. But the thought process is still there because you have the same needs, but can you maintain the positions that we had you get into that we’ll get you those needs under higher intensities? Yesterday he did.
Tim: And I like that. It’s just it’s incredibly intriguing to me, this notion that human beings lose movement options, either via physical structure or secondary training adaptations, lifestyle factors. And then it kind of, and I say this as a physical therapist who makes these changes on a daily basis, it shocks me that anything that we do has the power to override whatever stimulus came before to lead to that decrease in variability.
Tim: You know what I mean?
Zac: Yes. Because you’re looking at reps time, all that stuff.
Tim: Right. I mean, it’s almost to think anything in the gym could actually have that prolonged, have an effect. I mean, it also brings up the issue of in a perfect world. Nobody would need activities to regain movement options. That would be the goal, right?
You just walk into the gym and you train and your body adapts to the training with no deleterious secondary consequences. That’s obviously not the world that we live in, but it does seem like some people need a far lesser volume of these reset low-level types of activities. And they can kind of progress away from that over time. Whereas some people, for whatever reason, you know, need that consistent manual therapy, stimulus, or consistent low-level stimulus in order to make these changes stick.
Zac: Yes. Well, I think the key is the body has to deem it meaningful and novel and salient. And I’ll give you an example. If let’s say, you witnessed something terrible happened, anything. Something of 9/11 proportions and it happened right before your eyes. You would remember that for the rest of your life. And it might be just one moment, one instance.
And that could shape and shift everything that you thought before that. And I remember when I listened to Lorimer Moseley, he was talking about – I think my buddy Eric was talking about how taking NSAIDs could impair learning. And Lorimer gave the analogy if someone shot a gun right by you, you would remember that that happened, even if you were dosed up on NSAIDs.
Zac: Of it’s meaningful and novel enough, I think it could still lead to long-lasting changes.
Zac: Right? Now, does that mean the equivalent of you doing quadraped breathing is something like witnessing a horrific event? No. But your body might deem it novel and meaningful enough that it does remember that. And it does stick for some people.
Zac: So, my point by bringing that up is we just don’t know what’s going to cause things to stick. Whereas some people might need continual reinforcement over and over and over again to get meaningful change.
Tim: Something that, like David Gray and Gary Ward talk about all the time is, essentially that same thing, putting people in positions. But then if the nervous system likes that position, it’ll remember that position and there’s no need to revisit it as long as that’s what it reaches for the next time it tries to solve a particular environmental or movement task.
And that kind of makes some sense to me because if we think again about the Genesis of these like maladaptive, postures and positions, they are trying to solve a problem, get air in, maintain your ability to view your monitor while you’re sitting in a chair, they don’t emerge for no reason. This is a Seth Oberst quote, but everybody’s body is doing exactly what it needs to do.
The dark side of sensorimotor cueing
Tim: What you and I do with people involves a high degree of sensorimotor cueuing, right? Having people maintain particular positions. Do you think that there’s a potential dark side to sensorimotor cueuing and that it might put people sort of two in their own bodies if kind of left unchecked?
If most of their program is find your heels, tuck your hips, breathe this particular way, shift left. Do you find yourself needing to pull that out at certain times for certain people when you design programs?
Zac: Yes. I definitely think there’s definitely a certain portion of people who can fall victim to that.
Tim: Yes. What are those people typically like? I think I know what you’re going to say, but I’m interested.
Zac: Yes. They’re almost hyper-aware of everything in a negative sense. And then that becomes their identity essentially. I feel twisted. I feel twerked. It’s the person who gives me the laundry list of anatomical terminology that they shouldn’t know, but they know. That can definitely be a problem because it’s almost like when they get so intune to their bodies, but focusing only on the negatives.
So, with those people, yes, a lot of it is education “It’s no, you do not have to tuck your hips with every step you take every move you make.”
Tim: Because Zac’s going to be watching you.
Zac: Yes. In the creepiest way possible.
Tim: From a deep squat with a really long beard.
Zac: Yes. And then just like, no, you don’t have to feel your heels all the time when you walk and stuff like that. And it’s educating them that, “Look, we’re just using this as a strategy to increase your movement repertoire.”
And yes, I think if you can do that and frame the right mindset that can potentially mitigate some of that. Or I think that could also be where, especially when you get to loaded activities, a focus more towards external queuing might be useful. You know?
Tim: I like that. I think something that Michelle Boland, Coach Bo, and I talk about frequently. Shout out to coach Bo. Is the need to have things in a programmer or in your life that just make you feel like you’re a strong, capable human that doesn’t need to think him or herself into positions to be able to execute a task.
All of my practices have always been in CrossFit gyms. And I think that this is something that CrossFit gyms do incredibly well. And no CrossFit gym is perfect. And I have my issues with the moves that are commonly prescribed the over-reliance on barbells, but they do a really good job of getting people that haven’t been doing anything intense and getting them to not fear doing a hang snatch, doing a deadlift from the ground.
And I think that’s really impactful in a completely different way. Because I think people like you and I take into one extreme sort of becoming those clinicians, those practitioners that are really potentially propagating a lot of this like fear of movement.
Zac: It’s something I definitely think about as well. Because I do get people who come to me and it’s like, they’ve learned similar things to me, but they think about it in such a negative way. Like “I have to fix this anterior tilt.” Well, if you’re standing against gravity, you’re always going to have that because that’s the norm.
There’s a good podcast that Doug Kechijian did with Boo Schexnayder. He mentions that you should always be exposing them to intensity. And in order to produce intensity or move fast, you can’t think, and relaxation is paramount. And I think if there’s one thing it’s probably shifted this year, is really appreciating that.
But and here’s where I still think respecting biomechanics comes in. You have to make sure that you choose activities that are appropriate for that individual, that they can execute without having the risk for potentially performing it in a negative manner.
So, that could be doing a seated box jump, which it’s almost like the constraints of the activity, get them into positions that they need to. Or, I’ve been using a lot of fake throws lately.
Tim: To load a cut?
Zac: To load a cut or just to get them rotating pain-free or anything like that. Because you have to relax enough and move fast, but then you also have to stop fast. So, it kind of hits everything or just med ball throws. Like even though I talk a lot about biomechanics and stuff like that, if you look at how I actually program for someone, it has all of those other elements.
And I keep the concepts the same and the progressions appropriate with within movement options that they have available. But they’re not always having to think. They might think about the setup, but then when they’re executing the movement, I don’t have to think about anything. Because when you are thinking you can’t move fast, that’s when you get beat.
Tim: Yes. That’s what I like. I mean, one of my favorite lifts of all time is a single-arm dumbbell floor press, for that reason. Because like there’s still enough range of motion to load and you can let 98% of people that would ever walk into your training facility can do that drill.
And the single-arm just forces some innate sense of not having the weight, rotate you off your back. The goblet squats is another one. It’s like, it’s these things that people in our industry have been doing for a really long time because they’re just so simple and people can try hard, like you said, relax not think.
Zac: Yes. Or like sleds, med ball throws and carries. Those are all – if you have someone who is not exposed to much loading, that’s a great way to produce intensity and not have to think “Oh, you know, man, I love machines.” Love them.
Tim: I know. We know you do.
Zac: love them. In fact, one of my training is I’ll load up the BFR cuffs and I’ll go into my complex and just go ham on a leg press and all that. That’s great. I look good for one day of the week. And that’s my day for about 20 minutes.
Tim: Got a sick leg pump.
Zac: Yes. Just the veins out…
Tim: Bursting out of your khakis?
How to maximize patient communication
Tim: Speak to your journey in regards to your communication. How have you arrived at your current strategy for how to best communicate with probably both your clients and colleagues? How has that changed over the past five years?
Zac: A lot. I was for a while, obsessed with learning about how to best interact with people. I think I was a pretty shy kid growing up. Quiet, uncertain of myself. But I found that whenever you got someone else talking, people would end up really liking you.
Tim: Dale Carnegie.
Zac: Honestly. Exactly. Yes. I forget the phrases that he says in his book? There’s another one…
Tim: Is it be interested, not interesting?
Zac: Yes. Another quote I heard somewhere or this woman had met like these two higher-ups in English government and she talked to them about the first one. And she was like, “When I talked with this person, I thought he was the most interesting person in all of the UK.” And then she said, “But when I talked to the other person, I thought I was the most interesting person in all of the UK.”
And that really hit home for me. And I try to, when I’m interacting with people, get that vibe. But at the same time too, the issue that I’ve run with when I’ve spent all of this time, learning with my interactions is in the beginning, I was just asking a lot of questions, almost interviewing people. And sometimes that can be off-putting if done in that way.
So, to mitigate that, instead of asking a bunch of questions, there’s a technique called elicitation that I’ve been experimenting with. And how people are going to be like,” How is he eliciting me?” But basically, it’s like getting information out of someone without coming off as a threatening thing.
So, like if I come to Tim and I say, “Did you do this?” And say you did something wrong, whatever. Your inclination might be to go on the defense. And so, you might lie or you might say, “Well, yes I did. But it was because of this, this, this, this, and this.” And that’s not good. But if I wanted you to admit to that, I might say something or like a presumptive statement.
It’s like, “So what was it like when you did that?” Or “So you did X.” And almost making assumptions to try to understand the other person or inferences based on what they said. I think helps build a greater connection because it shows that you not only are listening to them, but you’re also understanding where they’re coming from. And I think that’s really important when it comes to human interaction and what I really focus on.
And here’s the cool thing about it. And there’s actually a really good book by this FBI agent that goes into this, “If you’re wrong about the assumption that I make…”
Tim: The inference.
Zac: The inference, that’s still, doesn’t lead to a negative interaction because people are so willing to correct any mistake that you make, but you’ll still get the interaction. Like in the book, he talks about, if you’re talking politics with someone, you might actually say someone has, I don’t know, they say something and they’re a Republican and you make the inference like, “Oh, well it sounds like something you might’ve gotten from FDR.”
And they might get so adamantly taking it back to like, “Like no, that’s because Ronald Reagan did this, this and this.” And so, then now you actually know their political bias and you didn’t even have to ask…
Tim: That direct question.
Zac: Yes. And so, I think not having direct questioning can provide a lot more useful information because when you question can come off as interrogation. That’s like some of the logistical things. But I think even more important than that is having good body language with someone.
We were talking about Bill Clinton. One of my clients knows Bill pretty well; has met him multiple times. Everything you read about Bill in a positive light, obviously he’s done some questionable things. But from an interaction standpoint, is a hundred percent true.
And he has five different things that he thinks about when he’s interacting with someone to build a rapport:
- Eye contact
- Close proximity
- The person’s name
- Direction facing
Zac: So, like now if you do all of that at once, that can be a bit much. But if you’re alternating among all of those variables, you can build an intimate connection with someone and have good rapport.
And so, when I’m interacting with someone, I do think about those things. Not so overtly that it’s like, “Okay, let’s hit point number five.” But those are things I think about incorporating whenever I’m interacting with someone, you know? And there’s a reason why I try to sit on people’s left most of the time, aside from it makes my neck more comfortable. And that’s because the right hemisphere of your brain is where your emotional centers are. So, in theory, if I’m sending more information to that side, I could potentially build a greater emotional bond with you.
Zac: You might be hearing this and it’s like, “Oh gosh, this just sounds like every interaction is Zac making is this calculated thing.” But it’s not that. It’s not if it’s genuine. I think the reason why I dove into that so much is that I just wanted to connect with people, you know?
Zac: I think back in my younger days, I was not in the best place mentally. I’m shy. And I didn’t want that because human connection is something that we crave. So, if you can do anything that maximizes that, so it’s beneficial for both parties or all parties involved. I don’t think there’s anything malicious about that. And that’s something we should practice as a skill just like anything else.
Tim: And it’s intentional until it becomes automatic.
Tim: And then it becomes automatic because frankly, a lot of those things are probably some of the best ways to connect with people. And I’m right there with you. Like you know, I think 90% of the reason why I do what we do is the ability to connect with people. I used to think it was the biomechanics and it’s not, that evolves, that changes, but that connection…
Tim: You know, we’re in kind of rarefied air in terms of healthcare practitioners.
Zac: Yes. And that’s why I always wax and wane with manual therapy, but I always come back to it to some extent. Because touch is a form of connection.
Tim: Yes. And its proximity without threat. Right. It’s not this interview type of vibe.
Zac: Yes, absolutely.
Tim: Although we have a good 90-degree angle situation going on right now,
Zac: And there’s a reason for that. So, and especially too, this is an interesting, a little difference between the sexes. If women, when they’re interacting with each other, they generally face each other. And that’s probably because they’re generally more social creatures than us. They have more agreeableness and things of that nature.
So, if you think back to like Hunter-gatherer times, that would be a useful thing. And so, that helps build more intimacy, but men who are close generally do not face each other. And the reason why is because when you’re facing a man directly, it almost comes off as aggressive. Like you’re going to challenge someone.
So, that’s why like, you know, bros, when they’re hanging out, they’re always like sitting. Right. And I think that there’s a reason for that.
And so, you can also based on whether it’s someone’s male or female, that can also influence the interaction depending on what direction you’re trying to go. So, it’s important. It’s an important thing to recognize if you’re working with people.
- Choose activities and people in your life that bring more energy, which will allow you to be a more productive member of society.
- Failure allows you to learn from your mistakes and create the life you want to live.
- You must push to great, but reconcile that some things are good as is.
- Movement behavior change requires novelty, which is different for everyone.
- Sensorimotor cueing can have negative impacts on certain people; mitigate this through education and appropriate exercise selection.
- Pleasant interactions are achieved by being interested, elicitative language, and effective nonverbal communication.