[00:00:03] Chad: “Reckless In The RACK” series is because this is now part two, this is our second. This is where we have little story time. And it basically is where, Nick, and I share stories from our patients. And that's why we call it “Reckless In The RACK” because some of these stories pretty reckless.
[00:00:29] PODCAST INTRO: Welcome to “In The RACK” podcast, where we provide you with the practical framework for breaking PRs in all facets of health and wellness. We are just a couple of bros giving you the simple house in a world of complex wants. No filters, no scripts, no rules, just straight talk, talk tune. Now, let's get into the rack with your hosts, Dr. Chad and Dr. Nick.
[00:00:55] Chad: Alright, everyone. Welcome to Episode Number 10 of “In The RACK” podcast, I'm your host, Chad. And with me is my co-host and fellow physical therapist, Nick. To start 10th podcast episode, first milestone is pretty sweet. I can't believe we've actually hit the double digits. I can actually remember when we were thinking about the first episode and that took two years.
[00:01:17] Nick: That’s so true.
[00:01:18] Chad: So it's good. We've just been banging these things out. And we're just having such a blast with these things. So in honor of the 10th Episode, I think it's time that we get a little reckless in the rack again, and this by again, it's the second time we're gonna get “Reckless In The RACK”. For all of you guys that listen to the last “Reckless In The RACK” that actually did pretty well. And we get a lot of great feedback on it. So I think we're just going to roll with it and just kind of keep it going. So for all of you that are just following us now and don't know what the “Reckless In The RACK” series is, because this is now part two, because it's our second one. This is where we have little story time. And it basically is where Nick and I share stories from our patients. And that's why we call it “Reckless In The RACK”, because some of these stories are pretty what we call reckless. So we'd like to share these stories, not only because they're reckless, but some of these stories actually may sound familiar and that's perfectly okay. We hope that some of these stories sound like your story. In fact, that's the exact purpose of the series. So we hope that it does coincide with some of your stories only because you can maybe benefit from some of these stories. And actually what we're seeing in results to these stories. We honestly didn't really even know which way this was going to go. We thought it was kind of cool upside down. But we got some pretty good feedback. So we're just gonna keep it rolling. And just in case, you guys were wondering, Nick and I have plenty of stories. So this could go on forever. So if you guys keep liking it, we're just going to keep doing it. So for all of you that are just joining us, in this episode, we are going to provide just a few quick stories and give our two cents on the story. So what do we get for our first story here, Nick?
[00:03:02] Nick: And just to reiterate to we're not trapped in telling you these stories that may sound like we're bashing other people or other providers, that's not the case. We’re not trying to put ourselves on a pedestal, we're simply just trying to urge both patients clients to advocate for themselves, and then other practitioners out there to continue learning, continue listening continue growing, because the fields, really all of healthcare is changing. We're learning more about the human body every day, and we've only scratched the surface. So you have to continue learning out there in order to provide the most optimal care when you're dealing with human beings. And that's all we're encouraging people with these stories. We're just trying to enlighten people to that. And before I get to my first reckless story, I just want to tell a little another little story. So, Chad, and I were working now on our break. I think it was a Friday, so everyone else was gone. So we normally take a break from 12 to get our workouts in in the middle of the day, kind of shut the clinic down still answer the phones. But nonetheless, it was a Friday afternoon was slow. So it was we pretty much closed down a little early. Chad and I were just getting after it. I'm dripping, dripping wet with sweat. Like always, that's not abnormal, Chad's got a tank top on because Friday days over. So we're both lifting. And we notice on the camera that someone's up front, so I'm dripping wet on my chat. You gotta go man, you gotta go check this out. So it was a woman who was inquiring about physical therapy, and she must have asked Chad, probably five or six times wait, so this is physical therapy. She was so blown away that one a physical therapist would be in a tank top two that a physical therapist would have that physique. And three that music was blasting in the background and weights were dropping on the floor.
[00:04:47] Chad: Honestly, didn't believe a word I was sending until we actually started talking about rotator cuff repairs. And then she was like, “Oh, I'll just take this brochure”. I was like, “Take that.”
[00:04:56] Nick: So it's pretty funny, but nonetheless, I suppose here where it was giving you more on the story. Moral the story is find yourself in physical therapy clinic that's just like that you walk in and you're like, Whoa, this is this can't be physical therapy, you actually question it that may be a place you actually want to be.
[00:05:09] Chad: And don't judge a book by its cover.
[00:05:11] Nick: Correct. Don't do that. If you see a book with a mohawk on it.
[00:05:14] Chad: It's probably a good read.
[00:05:17] Nick: So anyway, let's get into the first reckless story. So this is one of my favorites only because it's one of my favorite patients. And again, we're gonna give these pseudo names, fake names, whatever you want to call them, full names. And this one is going to be so those med balls SPRI, I don't even know what the SPRI stands for. But the med balls that say, I call them SPRI. So this person is going to be SPRI because this is an 81 year old male.
[00:05:44] Chad: Is he SPRI?
[00:05:45] Nick: Exactly, why I went with the name SPRI. Because this individual is the definition of SPRI, still so lively. Nonetheless, this individual I saw a few years ago following knee surgery, and then was gone for a while and then came back to me. And when he came back, I was like, “What happened?” Come to find out he had surgery on his low back a couple months prior, and actually did pretty well with that was gaining back strength, all that kind of stuff, mobility after the lumbar surgery, and I believe it was just a laminectomy. But at his I believe it was eight week follow up post low back surgery, expressed some concerns about how his balance had declined a little bit to the PA wasn't even the surgeon yet. And the PA was like, “Whoa, that might be your neck, we got to take some images of the neck”. So before the surgeon and the doctor even gets in for the checkup, they take images of the neck 81 years old, , you're gonna find some arthritis, all that kind of stuff. So now they got this in front of them this image and they're saying, “Oh man, we got to do something about this neck, and they started asking more questions neck pain. Of course, he had a little bit of neck pain here and there”. But this guy downplays everything. So now they're digging, digging, digging. And they're trying to find out what's going on with his neck. Nonetheless leads to a seventh level cervical fusion only three months after his lumbar surgery. So not even saying that this surgery wasn't warranted. Maybe it was. I didn't see him at the time. I didn't see him prior. I just know that what the images showed was arthritic changes and narrowing of the joint spaces. But nonetheless, they went and did a surgery only months after a significant back surgery. Now where my brain goes is we're not treating the individual there, we're just treating the image. We did back surgery. And now we see neck on the images and we do “Oh man, we got to operate on that too. We got to do the same thing we did the back”. So then this individual comes back to me and it SPRI is in rough shape. SPRI is now got a significant deficits and grip strength on one side significant deficits in proximal strength. So shoulder strength on the opposite side, numbness, tingling, can't move the neck, all that kind of stuff. So really just can't turn rotate to look behind him all that kind of stuff? And he still drives and he still works. So he needs to be able to do that kind of stuff. So literally, this was a situation where we weren't treating the individual or these providers weren't treating the individual. They were just treating the images and the injuries at hand or the changes, they weren't not asking the right questions, or at least I don't think so. They weren't diving into it deeply enough on an individual level to determine if surgery was actually the right course of action, especially at the time. If this was years down the road, it's a little bit different of a situation more target three months after a significant orthopedic surgery, we're gonna jump back in and do an even more significant one. It was pretty crazy.
[00:08:57] Chad: And I know who you're talking about. And SPRI is a SPRI guy. And I'll tell you this, this guy started with physical therapy with us and actually progressed to training with Nick and he trains with Nick, once or twice a week or something?
[00:09:09] Nick: He's on and off ways. He's mostly once but he was doing twice for a while. And now it's just once, he still works like crazy. He works more hours than we do. He's constantly working. So I give a guy a ton of credit.
[00:09:25] Chad: And he's the most grateful guy we've ever probably met.
[00:09:28] Nick: Absolutely. He comes in here and works hard, but I feel so bad because a lot of these things he struggles with now are a direct response of the neck surgery.
[00:09:39] Chad: And could have possibly been avoided every day, he had the right advice in the first place. Maybe you can either refer to physical therapy or another provider that could have helped him avoid that
[00:09:48] Nick: And he very well may have had radiculopathy numbness tingling at the time. He claims, he didn't but he may have according to whatever tests they did. But when he recounts this worry for me, he claims he didn't have the weakness and the numbness tingling that he has now, he just had the neck pain and the mobility. But again, we can work on that stuff. We're not going to give him full neck range of motion like he had when he was 20, but that’s okay, we can still make it functional. And he really just didn't have the opportunity to become functional again.
[00:10:22] Chad: And that's not unusual. And we always try to push people away from having surgeries, especially to the spine. I don't know what the success rate is, I don't know what the research is saying. I just know what from I've seen and it's not great. And actually this isn't one of my stories, but I'm just gonna say it really quick, because it's just a quick tidbit. The last guy that had a laminectomy surgery came in. He is super nice guy again, came in for he had some radiating pain. I think in his hip, maybe it's hamstring, it really didn't go all the way down to his foot, I think maybe occasionally. But it didn't really stop him from getting around and moving and doing his daily stuff like work. But he ended up having that surgery. And after that surgery, not only did he still have the numbness that he had previously, but he also had drop flip. And the surgeon was not going to take blame for that. And you know what, it's sometimes that can be inflammation, and that can settle. But three months later, no change. So he had to get a second opinion. And I think he's probably going to be undergoing another surgery for that. So unfortunately, but that's what it is. But that's why you guys listen, we got to create awareness on this.
[00:11:27] Nick: So when it comes to orthopedic surgery, a lot of times you should always be at least getting a second opinion, because there's a lot of ways to do things out there. And there's always more every year, there's more advancements, there's more techniques developed. So now, for example, take ACLs, it used to only be one technique that they did, and then there was two and that was a big thing, when there was two different graphs. Well, now we're approaching four, we're even getting more, we're approaching five, six different options for ACL. So you can see how they're when that's the case, they're always looking for a better way to do something. So if there's 5, 6, 7, 8 options for one particular issue, we should probably seek a couple of different opinions and then take all that information in ourselves. And that would be advocating for yourself. So that's why we encourage a lot of our people that come through our doors, that's what the doctor tells you, I encourage you to go see another surgeon and just get their opinion as well, if they coincide maybe it is the right move. But if they're opposite, now we got some thinking to do maybe get 30.
[00:12:31] Chad: And just to kind of piggyback off what Nick just said, especially with the ACL reconstructions, and this kind of has to do with if there's a surgery that involves multiple different ways about it, like hip replacements and such, it is all going to be dependent on the surgeon and sometimes a surgeon even though there could be a better way. They've been doing that technique for the last 20 years, and they're not going to change that. So that's not to say that's a bad technique, if it's not the technique that you're looking for, it doesn't necessarily mean that you need to go with that surgeon, I would get two opinions, if not three. If I was gonna get surgery, I get three opinions. So just know that just because they're offering you that doesn't mean there's no other options. They're just not experienced with doing those other options. So they feel comfortable.
[00:13:14] Nick: They might not be the person for you.
[00:13:15] Chad: Exactly. Good way to put it. So my story is a woman actually recently just saw her a few weeks ago, and we're going to call her Vivo. And for all of you guys that know Vivo’s, we love Vivo’s. And it's Vivo, not Vevo, by the way. So I learned that when I first started working with Vivo. So this woman Vivo, she is a 45 year old female. She's had a history of low back pain on and off for the past few years. Like we all have nothing crazy, not really too much on the radiating pain time side. But she did get occasional like hip stuff here and there, but it was very, very inconsistent. So she was riding a motorcycle with her husband. And this was I think, I want to say this was like three weeks ago, she was riding a motorcycle with her husband, and they ended up hitting a bump in the road. And if you've ever been on the back of the motorcycle, the motorcycle gives a little kick. And she wasn't ready for it. She actually didn't even know the bump was coming. So what an up happening as the motorcycle went down, it came back up and hit her right in the tailbone. And she felt like extreme pain right after that. No other pain besides right low back pain. She ended up going to bed that night felt, no significant change, woke up the next morning, and couldn’t move her eight foot. She had dropped foot overnight. So she's freaking out. She doesn't know what to do. She's like, “I gotta go to the emergency room. I gotta get this looked at”. She gets the emergency room. She tells the doctor everything and the doctor goes, “Okay, let's take an MRI of this. Let's see what's going on”. She said, “Let's do that”. So she gets into the X-ray room or the MRI room and the MRI tech or the radiologist comes up and says so I'm just reading your notes here and I just want to say that you might want to talk to the doctor and see if might want to get a different kind of image. And she's like, “I don't know what you mean”. So she goes in the office. And it the script for the MRI is for her ankle and not for her low back. This is wild. And the radiologist was blatantly upfront about he was like, “Listen, I'm not supposed to tell you this, but you have the ability to go to that doctor” and say, “Hey, listen, I want an MRI of my low back, like pretty much gave her all the steps to do, all she had to do is go do it”. So she's like, “Alright, I'm gonna do that”. So she went up to the doctor and said, “Hey, listen, I just want to see if maybe we can get an MRI image of my back”. And he's like, “Why would we do that?” She's like, “Well, I'm having a little bit of numbness in my foot in my chest dropped, I can't move my foot”. And he was like, “Well, how was I supposed to know you didn't tell me you had any back pain”. I'm like, “Oh my God”. So here we go. This is how it starts, like this guy can't even differentially diagnose the fact that she's got referral pain from her low back, nerve root compression, for sure. And she can't even move her foot. But let's take an MRI of the ankle. So that's how that first started.
[00:16:08] Nick: And the ankle, and they probably found some stuff that was wrong too. They potentially could have ended up doing something crazy with the ankle.
[00:16:15] Chad: Totally, that could happen. So this is how this, this is how this shit happens. But thankfully, she did not get the MRI on the ankle, she got the MRI, the low back, thank God. But following that she got her MRI results. And of course, it showed bulging between O4505S1 which we would typically see, but it wasn't severe. And we always say to all of our patients just because the image looks bad doesn't mean that you could be symptomatic. They say that 80% of everybody that gets an MRI to their lower back is going to have some sort of a disk issue, or degenerative disc disease or arthritis, there's gonna be something there, you would just say like this, they're gonna find something.
[00:16:57] Nick: Their percentages for back specific stuff on images are pretty close to age. So if you're in the 20s, it's the percentage in the 20s, or 30s, usually, sometimes groups into the 30s, depending on the study, if you're in the 30s, it's 30s to 40s, and so on, that you'll find something on there. And it's probably nowadays, I would argue a little bit higher because of our lifestyles. But chances are something's going to show up and there's a study that I said a lot of times with patients and it was one person having back pain, and they went to 10, they sent this individual to 10 different MRI centers. And there was 49 different findings across 10 MRI centers. Not one finding of the 49 was consistent across all 10, there was only one of the 49 that was consistent across seven out of the 10. So that just goes to show you the variability from center to center from machine to machine, even how they evaluated so what they determined to be a bolt herniation, all that kind of stuff. So specifically to the back, but this has been shown in other joints, knees with meniscus, shoulders with labrum and rotator cuff everything so every joint but it's much more profound in the in the back the spine. So when you get an image taken with a grain of salt, those findings do matter, because it's a piece of the puzzle. But remember, it's just a piece of the puzzle. We have to take in the whole picture. So you want to see a provider who is looking at a lot of the picture, not just narrowing down that picture. This is bad. We need to get know right now. That's usually not a good indication.
[00:18:40] Chad: 1,000%. And we've seen it both ways were in this situation where the MRI actually looked pretty okay, actually probably normal for most people, and she had dropped foot in symptoms on her leg. And then we've seen it the other way with the MRI looks horrible. And they're like, “No, I feel fine. I just went for a run this morning”. So it can go either way, and people are still amazed when we tell them that story. But it's true, don't let that get in the back of your head because it can certainly become a mental component to your recovery for sure.
[00:19:08] Nick: And that's not to say nothing needs urgent care or urgent surgery, there are situations conditions that would require something to be done immediately. But those are few and far between for the most part. And I would hope that the surgeon or provider is very, very adamant about that being this the common progression for that type of condition. Not so much like, this is a herniation. Who doesn't have a herniation? But if it's some obscure kind of random disease that you didn't know you had and they found it and they're shocked to maybe it's a little bit different situation, but those instances are few and far between. If something's urgent, you usually have a good indication that's urgent. Otherwise, try the conservative route first because you may surprise yourself.
[00:20:00] Chad: So she got the image. And the first thing she did is she's like, “What do I do now?” Nobody gave her guidance. Nobody said, “This is what you got to do.” Nothing zero. So she's like, “Well, I know chiropractors are good at treating backs. Let's do that”. And before I go any further, we have no qualms with chiropractors whatsoever. We actually worked with a lot of chiropractors in the area, and we work together collectively, and we get great results. But in this situation, she saw the chiropractor, and the chiropractor looked the image and said, “Yep, that looks great. I think we can definitely treat this”. And what did she do? Just joint manipulations all the way up her spine? And I'm like, “Oh, gosh”. And I only say that, because I know there's not one chiropractor that we work in the area that would do that. Not with this patient situation.
[00:20:44] Nick: Joint manipulations aren't bad directions, time and place.
[00:20:46] Chad: 1,000%. So she called us after that situation. And I immediately was like, “Hey, listen, and she's only like a 30 minute drive from us”. So I was like, “Hey, listen, let me do you a favor. Let me find you somebody that you can work with in your area”. That way you can get a better treatment that you're getting now, and I don't want to see you get worse. So she goes, “No, that's okay”. I just read this to you guys. So I'm like, “Nope, that's fine. That's cool”. So she came in, when we did the evaluation on her. Actually, one of the first things I did with her. I'm like, “Man, she's got dropped foot. I want to take a look and see what these reflexes look like. Not one fucking person didn't have reflex tests with her”. Not one person brought up a reflex hammer. I'm like, “Damn, that's wild”. So anyways, not like it's the only thing that we do.
[00:21:31] Nick: Because they learned it too long ago.
[00:21:33] Chad: But that was just like so astonishing to me. So anyways, so that was her and we've been seeing her for a couple of weeks now. And she's at the point where she can wiggle her toes, numbness is getting better. She's already gaining a little bit of strength back. Unfortunately, it is going to be a journey, but I'll tell you, it's way better than surgery.
[00:21:50] Nick: All right, one more story here. So this one, the name is going to be Concept Two, like the rower. So Concept Two is 17 year old female soccer player. This individual has been dealing with shin splints since freshman year soccer season, and Concept Two is going into senior year. Soccer season is started for high schools. Preseason is among us and games are probably starting next week. So hasn't had a soccer season where shin splints didn't impact and take her out of playing to some extent. And get the whole game, got physical therapy, doctors, podiatrists, and all that kind of stuff. So has seen a whole gamut of professionals. But what the consistent thing was each year soccer season is done. Well, we're gonna shut you down for eight weeks, let's shut you down completely for two months, no physical activity, and then we'll get you back into it. Of course, after eight weeks of doing nothing, your shin splints are going to feel much better. But all we did in that time, if I'm not gonna go deep into this but your body is going to lose capacity. And you didn't necessarily, you may have healed some of the inflammation that was going on. But your body hasn't really done anything to strengthen that area or to make itself more resilient to that in the future. So if you want to hear more about that, we have a couple episodes going into that. We had one most recently about the whole rest, and don't move you're injured area type of thing. So go listen to that one if you want more. But nonetheless, this was the information that she was being told her parents were being told to her parents were on top of her. Oh no, you can't do that. It hasn't been two months yet. Nope, you can't go play with your friends. It hasn't been two months yet. So everyone's on board with this. And then Concept Two comes back and it's feeling good at first during the winter because there's not much soccer. And then in the spring, when soccer starts to pick up again, shin splints come back. So this individual has pretty much lost or their soccer career in high school has been tarnished. And when they were younger, they wanted to play, Concept Two wanted to play soccer in college. Concept Two no longer wants to play soccer in college because everything hurts. And in physical therapy, I asked Concept Two what she had done in physical therapy in the past, and it was all passive stuff, the only exercise was stretching. Which I would argue that stretches can help a little bit when it comes to some shin splints, maybe loosening up the gastroc a little bit but we have to go deeper than just stretching and we can't just stick to ultrasound stem, all that kind of stuff. I wouldn't even do anyway. But nonetheless, if you're going to do some passive stuff to decrease in pain, we got to follow that up with exercise. If you want to do some stretching early on when things are really flared up and acute, then we got to progress into some load on those tissues of the lower legs and mechanics, work on some of those movement deficiencies, all that kind of stuff. But we're not going to get into how to treat, we're going to get into why this was a problem and absolutely tainted Concept Two's soccer playing career, she no longer wants to play. And this was this, the problem is, is that no provider along the way ever thought and said, “Wow, this hasn't been working, this individual keeps having this issue, maybe we should try something else”. That's totally fine to say if what you're doing isn't working, you either need to go back and find something that does and try other things. It doesn't have to be something crazy that might put the individual at harm. But if you try something, and it doesn't work, move on to the next thing. We have to get creative. So no provider along the way ever say, “Oh man, this is not working. They just kept saying I'm just gonna keep doing this, but nothing was working”. So now this individual is at a point where she's got this huge mental block to, so the mental pieces into it. And it might come down to she may need some intervention or treatment from someone who works in that realm working on mental therapy side of things. But this likely could have been avoided if we just approached it a little differently early on. And now she's pretty much just wants to changed her whole course, she doesn't even she's not even looking at schools to play soccer anymore. Because of this whole thing. That's matriculated of the past 3, 4 years, which is just too bad. Because no one ever said, “Oh man, this isn't working. I should try something else”.
[00:26:32] Chad: All too common, man. It's crazy. Well, if any of you feel like that, you fall into any of those situations than that now, you're not the only one, number one and number two, now you know where you need to go, or what direction anyways.
[00:26:51] Nick: And providers to hold on. And providers that might be listening, if you're not being effective in helping someone through something, ask for help collaborate with your colleagues, or reach out to another professional. That's the beauty of social media nowadays, you can reach out and develop relationships with people across the globe. They can be mentors to you, you can be mentors them, reach out, ask for help. There's nothing wrong with that just because you admitted that you don't know how to best treat said condition, that's not a negative thing, that's actually a positive. So collaborate, reach out and ask for help, all that stuff is good, it's a good thing to do.
[00:27:29] Chad: I'll even kind of piggyback off that and say that we work with a lot of physical therapists in the area as well. There's one group that is exactly like that, they have no problem saying that, “All right, we have an ACL at this point in time, three months usually, four months post-op, and they're at the point where it number one, they don't have the facility. And number two, I honestly don't think that they have the capability because that's I'm sure that they do.” I just think it more comes down to facility and being able to progress these patients like they need to, so they sell them to us and we do the same for them. So we can see post-op off the bat. But in terms of our model, their bests almost even seeing them and then we can push them once they get to that point, at phase two or three, when they're ready to be kind of pushed to that next level, we're there for them.
[00:28:23] Nick: And if you've been here before, you know that pretty much all everyone who walks through the doors knows both Chad myself, as well as everyone else who works here. But you guys know both of us, because we collaborate all the time. We're constantly talking back and forth about certain situations, obviously, if it's okay with the patient, but everyone kind of loves that environment. And it's not like we're talking about it with other patients we're talking about among each other. So we can bounce ideas off of each other. So someone may come in that I'm seeing, but they walked by Chad, I'm just not in the room at the moment. And Chad's talking to them about how things are going. Now they're feeling that positive energy in that positive environment, because he's not even my physical therapist, and he knows what's going on, or he's asking me these questions. So that matters. It absolutely matters. And that's the culture that we have tried to, it’s so hard to create.
[00:29:17] Chad: Absolutely. And that makes it even easier. Like, if you go on your one vacation for the year, and I gotta watch your patients. I can. There's not a lot of backlash that we get there. All the patients are very happy to work with either one of us and that's great. That is part of the culture.
[00:29:33] Nick: That's a good point. I've never had a hard time when you don't leave much but when you've left for like conferences or something, and never had a hard time telling your patients because I feel like I already know.
[00:29:41] Chad: Exactly. Because we're all so close as we're treating so we're all just kind of like in it together. So it works out. We love it for a little too sometimes. So what do we got going on for next episode, Nick? What do we think? It's gonna be randy. It’ gonna be a good one.
[00:29:58] Nick: We’re gonna get into it a little bit. So right now it's mainly in the physical therapy world, but it's probably gotten over the last couple of years with regard to manual therapy, so hands on stuff, whether it's something like grass fed or instrument assisted soft tissue mobilization and copying, stuff like that. The rehab world is very torn. So you have extremists on one end that are very anti manual, they won't even put their hands on someone. And then you got extremists on the other end that are gung ho manual, only manual, they barely do any exercises. So we're going to talk about that we're going to get into some nitty gritty stuff, we might make some people angry that’s okay. We're not trying to be mean. But we are going to talk about it. And at the end of the day, we're always right in the middle on most issues. So that's where we're going to be but we're going to talk about both sides.
[00:30:54] Chad: And I'm just going to preface this by saying that our practices, would you say percentage wise, maybe like, 60% exercise, 40% manual, maybe 70-30?
[00:31:04] Nick: I would say it probably used to be a 60-40. It's probably more 70-30, 75-25.
[00:31:09] Chad: So we do definitely have a manual therapy.
[00:31:11] Nick: And that's perfect. And that's where physical therapy, sorry, I keep interrupting you. And that's for physical therapy, if you come here for training, because we do strength training as well. You're not getting any manual. You might ask us to do something on you're not you're exercising, you signed up for training, you are trained for that.
[00:31:27] Chad: That's the truth. And I'll tell you right now that it's almost a 50-50 split, we get about 50% training clients and 50% PT patients. So it's fun. But I will say that this episode coming up is going to be a good one. And I'm also going to say that it's going to be worth a listen. Whether you're a patient, practicing provider, currently, or not, or your student in the program. And I've got a story behind that too. And I'm only going to say it right now, because I'm probably gonna say it again in another week. But if he's listening to this, no disrespect. So if anything, take it as feedback because we had a higher come in. And he's been following some of these people that we're going to “to talk about” next week. And there may be some call outs next week. And that's okay. I'm with that. And it's not in a disrespectful way. It's an awareness way. And I say that because this kid just came fresh out of school to have him observe us for a couple of days. And I said, “Hey, listen, before we talk about anything further, I want you to see how we do things here and see if we're a good fit for you. And you're a good fit for us, blah, blah, blah”. So at the end of his last day, he came up to me and he said, “Man, I'm really so surprised how much manual therapy you guys do”. And I was like, “Taken aback”. I was professional. I was like, that's just how we do it here. But inside, I was like, “You have no fucking right to say that you just got out of school, you don't even know man, you haven't even touched. I've seen more patients this week, you've seen in internships, don't even tell me what works and doesn't work”. So I'm getting all riled up about it. But that's where the profession is going. And we have all these influencers, don't get me wrong, they are great. But they take it too far in terms of trying to feed these people into and their little cult. And that just needs to end these kids have to make their decisions for themselves, or these providers have to make the decisions for themselves, where they think that they fit on this tear, whether they're more manual, not more manual, or maybe they're like a half and half or like us where it all depends on the patient. So I want to make that upfront and clear. So I'm probably going to put the ‘E’ on that one right now, because I think it's going to get a little rowdy. But it's going to be a good one. And we're excited about that. But what I really want to say is, “I think we're trying to bring more awareness to that situation, because it honestly just needs to stop”. And like Nick was saying, there's such a huge disconnect in this profession. It's crazy. Like, there can be nobody that can be happy for each other like, “Wow, that's a really cool technique”. Instead, they go on your fucking social media, and they're like, “Dude, that doesn't even work. That is so dumb”. It's like, “Dude, keep your comments to yourself. Last time I checked, you have no followers. What the fuck?” So it's like, you get all up in like that. And then you get trolls that think they know everything. And it's like, “Dude, you're still in school. I'm sorry” so anyways.
[00:34:14] Nick: If you couldn't tell, Chad, spends way too much time on social media.
[00:34:18] Chad: Imagine how much more time I'd have my life. Oh my God, but anyways. And you guys all know what I'm talking about. Like, this isn't new news. But we want to say it because not a lot of people come out and say it, but I have no problem saying, I got nothing to lose.
[00:34:32] Nick: We might have put the next episode on YouTube and see the video.
[00:34:38] Chad: Ad see my face exactly. So anyways, I think it's apparent that these stories are not only crazy, but in our words, we call them reckless. And I think we can also agree that the healthcare system needs some work. Unfortunately for a lot of our patients, the healthcare system has failed them and that's unfortunate. And we're sorry for that. Even though it's not our fault, we know that we're kind of clumped in this whole system with you guys. So we do get a little fired up about it, because honestly, it's quite disappointing being in the profession and being in the healthcare system, and knowing that it didn't serve you well. So we want you to know that we're on your side. And that's the main reason why we're trying to create awareness here with this podcast. So we understand it will never be perfect. But seems that we kind of hear these stories just a little too often, almost every single event that we have probably has a story that we could probably say. But in any event, we hope these stories, definitely either triggered something in you to think, “Oh man, that kind of sounds like me, or somebody you know and maybe you can give them a little advice or a little direction that way”. They don't kind of go down the path that are the patients have saved them the trouble of getting maybe an unnecessary surgery or a treatment that maybe probably isn't the fit for them. So in order to end this, we want to say that if you are a health care provider, and you are listening to what to what we just said, “Don't be reckless with other people's health”. I think that's like the big thing here. As providers, we can't be reckless with people's health. And for all of the patients that are listening, you shouldn't put up with the providers that are reckless with yours.
[00:36:20] PODCAST OUTRO: Thank you for joining us “In The RACK” this week. Make sure to subscribe so you don't miss out on any future episodes. You can also find us online at proformptma.com, or on social media at ProForm PTMA. And remember;
“If you train inside the rack, you better be thinking outside the rack”.
