June 5, 2025 • 45 mins
In this episode of the Healthy, Wealthy & Smart Podcast, host Karen Litzy is joined by orthopedic physical therapist Matt Huey to discuss the importance of building independence with patients through effective communication and empowerment. With nearly 15 years of experience in outpatient orthopedics, Matt shares his diverse PT background. He dives into strategies for meeting patients where they are in their healing journey and fostering a collaborative environment in therapy. Tune in to discover how to enhance patient empowerment and promote more effective therapeutic relationships.
Time Stamps:
[00:03:12] Patient empowerment through education.
[00:04:42] Soft skills in physical therapy.
[00:11:23] Building patient independence in therapy.
[00:12:20] Mechanical pain explanation.
[00:18:02] Home exercise consistency challenges.
[00:19:36] Incorporating exercise into daily routine.
[00:23:13] Effective communication in therapy.
[00:27:47] Honesty in patient treatment.
[00:32:28] Special tests in therapy.
[00:35:15] Patient communication and independence.
[00:40:38] Asking questions for growth.
[00:00:00] Health, wealth, and smart living.
More About Matt Huey:
With nearly 15 years of experience as a physical therapist, Matt has established himself as a highly skilled clinician in the realm of orthopedic care, both in patient care and clinical expertise.
Matt earned a diploma in Mechanical Diagnosis and Therapy (MDT), showcasing his mastery in assessing and treating musculoskeletal disorders. He is also a Fellow of the American Academy of Orthopaedic Manual Physical Therapists (FAAOMPT), which reflects advanced skills in manual therapy approaches.
Matt has demonstrated leadership by operating clinics throughout his career, leading them to deliver the highest quality care and serving the profession through various roles. In his time, he has not only assisted in the passage of the licensure compact bill into law, but also brought about a motion for the APTA to support pay transparency as a way to help improve wage disparities.
Matt has also leveraged social media as a way to not only entertain people through humor, but also educate a wider audience about
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:02):
Hey everybody, welcome back to the Healthy, Wealthy, and Smart Podcast. And
today we're going to be talking all about how to build independence with
your therapist, why communication is so important, meeting
them where they're at, and to help on
this journey of patient empowerment. I'm
really happy to be joined by fellow physical therapist,
(00:24):
Matt Huey. He is an orthopedic PT
in Texas who loves not only helping people get better,
but entertaining people on social media, which we
will get to his Instagram towards the end of the podcast. But
I'll just say, check out his Instagram, Matt underscore PT, underscore
DIP, underscore MDT, because it really is a lot of
(00:46):
fun. And we'll talk a little bit about that later and the evolution of
that and um, how people can get in touch with you, but
It's a pleasure. Now, before we get into all of this patient empowerment,
can you give the listeners a little bit more about your
(01:08):
So I've been a physical therapist, uh, coming up on 15 years.
I've been in orthopedics the entire time outpatient orthopedics,
um, from Mississippi originally. So that's, um,
yeah, that's my accent. I'm in Texas. So I say, I say I have
a, a Southern accent, not a Texan ass accent. It's a
little bit different, but. Uh, say I became certified
(01:31):
in the McKinsey approach MDT back in
2013, then completed the diploma in 2020, no,
excuse me, 2018 fellow of the AOPT in
2020 and certified manual trigger point therapist. as
well. So I do a lot of manual stuff. I've always
(01:53):
really enjoyed that. Also, I've
really enjoyed the McKinsey approach, and that's been
the staple of how I work with patients, but
also educate them and get them moving. And
with all that being said, I tell people I'm probably the most educated hillbilly
(02:19):
It, it, you know, people, when they get
around me that are not from the South, they'll
say like, I noticed I have this little twang. I said, I think it's a sympathy thing that
people said that you kind of pick up a, an accent of people, whomever that
Yeah. Yeah. I remember when Madonna had that British accent when she
(02:40):
Oh, yes. Yes. There you go. Dating ourselves
I know. That's OK. The younger viewers
go look it up. You'll love it. OK, so
you've been a PT for 15 years, have a lot of advanced
training. How do you, before we get into some of
(03:00):
what I talked about in the intro, how do you feel
that the training you received better equipped you
So I really feel like it gives a deeper
way of explaining things to people, to
understand like what they have going on. And,
(03:22):
you know, we talked about empower and to say like doing this can
help you reach your goal. Uh, also like understanding
what is going on with somebody and feeling calmer when
somebody just starts, you know, we'll let you know. I just
had this patient today, and my neck's been hurting me on this
(03:44):
side, and it's going down my arm, it's up here, it's been in my
left side of my back, and down to my leg, and it hurts when I do this, and this, and this, and this. It's
been like this for years. I never get any relief. And
I've met people that hear that, and they're just like, oh my
gosh, what am I going to do? And then sitting there, it's like, okay, Let's
just take this a step at a time. We're going to, let's focus on
(04:05):
one thing. Let's talk about this. Let's dive into that. Let's go into
here. Okay. Now we can move to the next thing. So it feels like it's
a much more thorough process in assessing someone and
being able to hit the points and, and that there end
up leaving the situation that leaving the assessment or
leaving the evaluation. Like this person understands
(04:27):
me, what is going on. I feel confident in that they can help me.
Yeah, and I think if you can. really
hone in on those soft skills through advanced training,
then I think it's all worth it. Because I think a lot of people, certainly
in the physical therapy world, when we see those titles after
(04:48):
the name, we think, ah, they're a manual therapist. They just want to go in
and move people around and manipulate things. And they're
not doing all the other stuff. And
I think that's probably a bad preconceived notion.
One big thing that, uh, and I tell people, are you familiar with MDT? Okay.
So, you know, the, the classification system.
(05:11):
So if anyone is, if not familiar with MDT, um,
most people know about the classification, dysfunction, derangement, postural,
and other. Really what the diploma and
the fellowship, uh, helped me with is that other category.
Because if somebody comes in with back pain that responds to repeated
extension and lying. Just like, do we need
(05:34):
to spend more time working, teaching you what to do with that person? It's
that person that, um, it's like, I
tell it, I didn't tell like, this is the hard patient. I get this pain
on the side of my back, like left side of my back when
I'm brushing my teeth. Like, and it's like a three.
(05:54):
It doesn't bother me with anything else. Like, it's just like, it just right here. Or
like I put my contacts in or it teaches you
how to help that patient. Cause that one's a challenging one.
That one that just doesn't respond to like
repeated motions or just, it's just all over
the place. It helps you with those other, as we
(06:15):
classify them in the other category. So it really helps you
Yeah. Yeah. I mean, I'm not certified by any means
in MDT, but I do use the
evaluative procedures when
I have a patient who I might be seeing for a knee for knee
(06:37):
pain and comes in. Oh, you know, I just went on like
a longer hike and I'm not used to having this pain and it's kind of
radiating down into my glutes and maybe a little bit into my
you know, which I'm sure you get all the time. So I think it's really great
that you can use this framework in order to help those
patients who maybe have not gone on to see a doctor yet, or
(07:00):
you're seeing for one thing and they come in with something else and
you can give them your
best hypothesis as to what might be happening. And that can
Yeah, I also feel with some of the specialized training
that unfortunately, you know, you hear about patients
(07:22):
that failed therapy. All the patients, they failed therapy,
so they need it, or therapy didn't work. They needed the injection, they needed a surgeon, they
needed this stuff. But it's like, did they really fail
or was maybe the therapist wasn't the correct therapist
or they didn't explore this or explore that. And
it's like, it's not a fault of the therapist. Like I never say it's
(07:43):
not your fault. But I often look at some of the specialized
training, like with physicians, you have general practitioners and
you have specialists. And the general practitioners can help
people, and then sometimes they're like, no, no, no, no. This is not something
in my realm. Let me send you to this person over here. So that's what I
feel like it can help with those little things like that, where
(08:04):
someone else may say, this person failed therapy. They
need the next thing. When it's like, really? They didn't. They
need it a little bit more. You need it to look here. You need it
to push into that and to really see if
Yeah. I hate that term when people say, oh, they
failed at PT. It's
(08:27):
just, it's so like, what? Cause I've,
I remember I had a doctor refer patient. I'd like a
medium, I'd say maybe moderate rotator cuff tear. Okay.
You know, you can do exercises. You don't have
to have surgery for that, but the doctor's like, try PT for
a month. See if it helps. Oh,
(08:51):
PT for a month for a moderate like men to moderate rotator
cuff tear like how about PT for six months and
see if that helps right so so then you get the email well the PT
I've had that, which I've thought was very infuriating as
well. Somebody with back pain. I've got, you know, this person's 68 years
(09:14):
old, has back pain for 10 years, is incredibly
stiff, doesn't move. And they're like, yeah, you get a
two times three. It's like, do you remember
physiology? Like we don't even get a physiologic change
really in that short period of time. And
how can you say this did not work? So
(09:39):
I had this with a patient one time. He came
in and he had had a
previous rotator cuff surgery. And he told me, He said, well,
I don't think the therapy took. I'm like, what do you mean it took? Would
it take your keys, your wallet? What did it take? And he said,
well, it didn't really work. And I said, well, he was a teacher.
(10:01):
I said, OK, if you have a student that
fails, what's the first question you're going to ask that student? did
you do your homework? And what are you going to say when that student goes, well, no, no,
no, I paid attention in class, which is like the same thing as you. So
you didn't do the work on your own. So no, you didn't,
you have to keep, keep that up. And I would say that
(10:22):
with, you know, I apply a lot, use a lot of analogies and
I kind of use it for a lot of stuff to say like, When you get into shape, you
don't exercise and all that stuff for like a day until
people's like, you don't get up, run five miles, ate
a bowl of cereal. I had a salad for lunch and I went to the gym for an hour. I don't wake up
20 pounds lighter the next day. Does that say it didn't work? No. It's like, it
(10:42):
takes time. Same thing if you did that over six months. And
then all of a sudden you stop. Did you say like, no, no, no, the, the, you
know, the healthy eating and the exercise didn't work because it didn't stick. Like,
no, you have to keep some of this stuff up for a period of time. And
so that's what I really get into educating people about
to say, like, really give this a significant amount of time. And,
(11:05):
and really seeing early on, that's something I tell patients. I was like, I'll
be the first one to tell you this is not working. So.
Yeah. And that kind of gets into the bulk of
our conversation today, which is how to build that independence, excuse
me, how to build that independence with your patients. So
(11:26):
can you take us through how you
do that with your patients? Obviously knowing everyone's an
So really to start off, just the same thing
that we always talk about, listening to the person, validating
what they've got going on. So that just
(11:48):
really starts with it. you
know, the assessing their movement and then saying,
based upon what we may do, to
say, oh, you may have this or you may have this going on, but
let's try this to see if this gets you better. And
then while they're doing it, we may be explaining, I may start explaining
(12:11):
what's going on. So, if
somebody came, the most common thing I see is mechanical pain. So,
person, I explain, you know, we have different types of pain. We have an inflammatory pain,
visceral pain, a nerve root. So, we can have all
this type of pain, but you've probably felt mechanical pain before,
like when you sit too long. And then you get up, you start walking, and you're like, oh, it
(12:32):
feels better. That's really what we're doing. And
then you see, like, OK, well, what does this mean? Well,
what does that mean? You know, they said, well, they told me on the MRI that
it's bone on bone. It's like, well, you know, nobody stuck you with a dirty
needle and gave you that. You know, you were fine two weeks ago. This
came on yesterday. You just didn't get that to happen. You
(12:53):
know, that's something that is very, very common. If you want
to look up any research about it, yes, you will see all
of this. And so really just explaining a lot of that,
answering questions is a really, really big
thing. I am seeing a positive thing with
a lot of people now is they don't want
(13:15):
to turn out like their parents or grandparents. By
seeing them saying, um, I've seen what surgery does
to people. I've seen what all that medication does and
going from doctor, I do not want that. And so
they, they're seeing some of the negative aspects
of the more advanced procedures. And so they're, they're starting
(13:38):
to hold, I'm starting to see more, there's like, I don't want to, I don't want to
do that. Or they're coming in
very afraid that, I don't know
why that did that. I don't know why. That
thing just threw me off there. I know it was so funny. I was like, yeah, that
was weird. Um, but, um, they're, they're
(14:00):
afraid to say, well, I don't want that. I
don't want that surgery. Cause the doctor said that
I'm going to have a surgery and that's not what I want because I've
seen it and I'm, and they're scared. And so when you
start in just saying like, no, no, no, no, no, that's not what we're going for.
We're not trying to go. We're trying to avoid it, you know? And I tell them
(14:20):
if you need it. It, you know, we can hold on to it. We'll put
it in our back pocket. They'll do that surgery next week, next month,
next year, 10 year, they'll do it down the line. If you need it, we will
Yeah, so it sounds like you have a pretty systematic way
when you're evaluating your patients. And I assume when
(14:41):
you're reevaluating patients or, and I mean, I don't know
about you, but I'm sort of reevaluating at every session. Would
you say that you do have like a
generalized blueprint that you're following for each of these
Yes, so I tell everybody, I'm
going to ask you how you're feeling when you come back and you're going to
(15:04):
give me one of three answers. You're going to be better or worse or the same. I
said, if you're in all three of those, tell us
something. If you come back better and you're like, Oh, it feels better. Cool. Great.
We're doing the right thing. We're keep going that path. If you come in the same
and you did your stuff at home. Then
we weren't the, what we thought was not the correct
(15:25):
thing. We can move to the, you know, differentiating between hip SI and
lumbar. We took one off the table. Now we can really
focus on that. You come in worse, something changed, something
changed to make you worse. Now we can go from there. I said, the only
thing that, um, will tell
that won't help us is if you don't do anything. If you don't do, and
(15:46):
I had somebody did that one time, they had a neck pain. really
forward head. And when they came in the next visit, they
said, well, I'm the same. Did you do your exercise at home? Yeah,
like one, two, three, four, five. It didn't work. I had to quit. It's like, no, you
didn't do enough. So it's assessing, OK, how
are you feeling? What are you feeling? And assessing
(16:10):
one of those functional baselines that we may have asked is, how
is this or how is that? How is this? Can you get your
stuff in at home? Can you show me how you do them? Okay.
And if somebody's doing them, it kind of goes into like, all right, let's start moving
you a little bit more and just start doing this and start seeing it. So it is kind
of a, it is a systematic way of progressing people
(16:31):
kind of. And also I look at like stability of stuff is
how I call it. So like
we use the classification of derangement. So like if I have somebody with
a neck pain and I'm going to kind of look at how that
when they come in that next visit, if they're saying like, I'm feeling really,
really good. I may do a little bit of exercise, but
(16:52):
then tell them, I don't want you doing this at home. I want to see how you feel tonight,
tomorrow, the next day, because you may say, well, it felt great.
Then you wake up tomorrow going, oh, oh. So, so
And if someone is coming in, let's
say it's their second or third visit and you
(17:14):
ask them, how were the exercises? I didn't, I didn't have
time to do them. I'll be honest. I didn't do them at all. So
we all run into those patients. We do not want to dismiss
them. So what is your response to
a patient when they come back and say,
I didn't, I just, I didn't do them. I didn't have time. I didn't do
(17:35):
this. I didn't do that because that happens. And so
if we want to empower our patients to be part of
the rehab process, what do you, what is your
response to them? And what can you share for our listeners that
So I get into the why to say like, well, what happened
with it? Was it, was it too complicated? Was there something else
(17:58):
going on? That's one thing I do with my home exercise. I don't give
people a sheet of them. I don't give you like, I
knew somebody that would give people 12 exercises, two
sheets with 12 exercises total. I'm like, I'm not going
to give you all that. I tell them, I was like, I'm going to give you something simple
to do. And I just want to do this to
(18:21):
see what it does. And I let them know the complexity
is not in the simplicity. The complexity is in
the consistency. And so I set
that tone, but if they come in to say, Oh, I know I just didn't have time
to do it or not. Well, why not on
it? And, and just really kind of get their rationale to say,
(18:43):
well, you know, I didn't have anywhere to lay down. Okay. Can
we, can we modify, could, could we possibly modify that?
Uh, you know, all work was, was just crazy or had
this. And so maybe try to find some sort
of modification to them. Um, I
am, I do try to be honest with them as well. When somebody says
(19:05):
like, well, can we just do something different? It's like, well, you're not
going to get the same results. It's like, you're going
to, you're most likely going to get your best results with this. So
can we fit it in? Um, I've also started telling people to
take like schedule it, like put it on your
calendar, you know, and, and I try to keep, I try to keep stuff under
(19:28):
five minutes. You know, if like, if you're able
to just kind of dose it during the day, uh, that
works, but schedule it just like, Hey, I'm going to do this for
five minutes on it. Um, and set
a place, you know, don't do it in the
living room in front of the TV. My dad was bad about that. He
(19:49):
would try to do exercises sitting in his chair watching TV.
It's like, no, no, you go to a corner and that's
your corner. So that is your time, your place
to do this. So I'm going to focus and do my work here.
And really saying like, just spend that time. on
it and you're going to get a really good result when
(20:13):
you start doing that stuff. Um, I've even had people,
um, there's some, uh, medication apps. If you need reminders,
there's medication apps that you can have them download that.
They do your exercises here. It'll
send you a reminder to do your exercise. And I've done that for, I've done
(20:35):
Yeah, and I love the fact that you're not berating them.
You're not saying, oh, well, you know, if you don't do the exercise, you're never gonna
get better. But instead saying, getting to
the why, and then working together
as a team to figure out a way that
you can get these little snacks in during the day. And that
(20:58):
That's a big one. Um, really when people start returning back
to their normal function, I tell them, I'm
like, you're standing at brushing your teeth. You
You know, you're standing over here, grab this, you know, stretch it, throw
this little thing in, put 10 reps here, do 20 reps
(21:19):
here. You can throw these little things in through your
Yeah, absolutely. I always tell people like, you're not
doing all, you don't have to do all
the exercise at once, unless you want to, unless you want to say, I
put to your point, 30 minutes into my schedule, this is
when I'm going to do all my exercises. But with some people, like
(21:42):
I have people like, oh, if you're waiting for the subway, just
do some heel raises. Oh, you're waiting for the subway, go against the
wall and do some pelvic tilts against the wall. You know, so
there are a lot of ways that you can incorporate home exercise programs.
It can't just be a blanket. You can't give the same thing to every person
(22:04):
in the same position at the same intensity level, et
cetera, because what works for one is not going to work for
Yes. And I let people know because sometimes they're like,
well, I've done this before. And I'll say, yes,
some of these things are wonderful to be done across the board. And
so they're a very common thing that we are going to use. And so it's
(22:25):
like, yes, I may use the press up for, you
know, 70% of my back pain page, but it's like, it works for like 7% of them. So
it's like, Yeah, so
you've done that now I may change it up as well because that gets
into an explanation Because people are like oh when
I did therapy five years ago This was one of the things I did
(22:46):
and I just did three sets of ten So I'm just I'm gonna reference that
old one and do that same thing and explain. No. No, it's
it is the same I want you to do it way more frequently
and we're not gonna focus on the other things we're really gonna focus on this and And
so they, luckily, if they've done it before, they
kind of recognize the benefit. And then when you explain like, no, no, we're using
(23:08):
it in a different way than the, oh, okay. Okay.
Yeah. And I just think
that what you're talking about here is all about communication
and how to communicate things properly, how
to communicate things with some empathy, how to meet people where
they're at. And is there ever a danger of
(23:34):
I would say that there can be, um, I try not
to give too much because until,
you know, um, this reminds me, I had an anatomy teacher before I went to PT
school. He's like, the brain could only absorb what the behind could
withstand. So if people started getting fidgety, he would be like, our class is
over. We were so far behind in that class. But I don't
(23:56):
tell people that you know, you're coming in pain. You're probably not
gonna retain a lot You're probably gonna
is Adrian Lowe says people remember two things how you made him feel
or excuse me the last thing how do you make it feel and the last thing you
told him and so I You
know talked a lot and I said, I'm probably gonna give you too much
(24:16):
information. I If you ever have questions, write
it down, come back, send me an email, text me, and I
will do any of this and let them know. I'll clarify anything.
But going back to that point as well, I think that there can be times when giving
too much Uh, when people are very kind of
like hyper aware of it, like, you know, I got this back pain
(24:40):
and I heard that disc problems are like forever and you got
to do surgery and then you have to go to this. And it's like, okay,
I don't really want to talk a lot about disc
stuff or back stuff. I have to be very
careful in what I give them because they could take that and run
with it because they could soon as they, they walk out the door. It,
(25:02):
the, everything got twisted up in their mind. And oh my gosh, he just
said, you know, this is just going to be forever. You know, telling somebody like, you
know, if you have back pain, once you're at a, what, 80 some odd percent chance of
having it again. I had somebody that one time walked
out the door. He said, he said, I'm going to have back pain again in the future. I
was using it in a reference to something. So it is kind
(25:23):
of like, let me gauge what, how you are. We're just
And I think a lot of that, um, you become really much
better at it, the more you do it. And it isn't experiencing
the longer you're in practice, the better. So for all the physical
therapists out there listening, if you're on the younger side within the
(25:44):
profession, just know that communication and
reading people and having those soft skills and motivational interviewing,
right? Because you and what about the,
um, cause this is something I just said today, I think like
with two different patients, but I probably say it at least once a week, you
(26:06):
know, I'm not sure, but I'll get back to you. So
what are your thoughts on the, I don't know, versus saying
something that I mean, like if
you don't know, don't make something up. So what
I'll tell you, I'll sometimes have them ask, um,
(26:28):
you know, ask a question. I'm like, that's a good
question. I'm going to find that out for you. Luckily, like most
of them don't mind that you pull out your phone and look that up. And it's something like,
you know, let's, let's have a lesson together and
let's learn about that together. And so I, I
don't have a fear of it. I do have some patients,
(26:51):
long-term patients that come back. They're like, when you
get that stinking look, I know you're wondering and
thinking, and I know the answer is probably just not going to
be fun for me. But they recognize is like, you
may not know, but you're going to go look and you're going to come back and tell me so
built that rapport. And, you know, I tell them I will find that out.
(27:13):
And that's sometimes when they come in, guess what I'm going to
tell you right now, I'm telling you right off the bat that, that next
Yeah. And I think that's a really important lesson for PTs, especially younger
PTs, because in school we're taught to always
have the answer. Right. Yes. And
so when you get out and you start working with patients and you don't have the answer, the
(27:35):
temptation is to make something up to make it look like you have the answer, even though
you don't have the answer, which can be worse. So the
best thing you can do is, and it's not a weakness to
Yeah, and that will go over to something about treatment. I
had somebody taught me, they said, don't try
to treat something, understand it before
(27:58):
you try to treat it. And I think that even goes into treatment when somebody is
like, again, we may talk neck pain or back pain, and
it's like, I don't have a directional preference. I
don't know exactly what this person is going on, but let me just give them some
stuff to make them better that I think will make them
better. And I, and
(28:18):
I, and I had mentors to tell me, it's like, figure out what's going on.
And somebody like that, I've taught students, make
them worse, sit there and try to make them worse. Because
if you make them worse, you can make them better. And so if, if
somebody has a pain or something, it's like, I
don't know what is this is. I don't know if this is your neck or your shoulder
(28:39):
or is it thoracic or whatnot, but I'm going to pick your neck and I'm going to try
to make your neck worse. And if I could, and if, and I will let, but
that goes to a lot of explanation as well. Yeah. We're
going to do this. Now, if you start to feel X, Y, Z, and you
know, this and that, stop. Then we know
what is going on. If you don't have that, we took that, we
(29:00):
moved that off the table. We can go to that next thing. But it, but
it's telling somebody it's like, I'm not a hundred percent. I have a few ideas.
Let's test this one. Let's look at what we have here.
Let's really test it and thoroughly examine it to see, is
this the, you know, what it is rather than you spending our wheels
(29:20):
Yeah, absolutely. Honesty is
always the best policy. So oftentimes I'll
say to patients, well, I think we have a hypothesis.
of what's going on. And we're going to work off that hypothesis and
see how you react, because it could be this. It could be
this. These are my thoughts. And how do you feel about that?
(29:43):
And involving them in giving them some agency over
those decisions, I think also goes a long way to creating
independence. And what
other tips or tricks do you
have? And let's keep those younger therapists in mind right now. For
those younger therapists who are
(30:06):
starting their first job and they're overwhelmed and
now they know it's okay to say, I don't know. How
else would you advise those younger
therapists to help with building
independence with your patients and being someone's physical
(30:28):
I just build that rapport with them. Just chatting with
them, talking about it, get them just talking about whatever. Um, you
learn quite a lot. And that's a big, just, just listening and
just, you know, just, but they're spouting about
what they can't do or their job, their kids or things
that they're sport, whatever. And people tend to like that. And you
(30:50):
can also kind of get a lot of information out of them as well. Then
you can find out what they like doing. Okay, you
like doing that, maybe we can work into doing those things as
well. Also, again, kind of going
over back to what we said earlier with
the younger therapists, don't be afraid to trigger pain. Like we get
(31:11):
this whole thing We don't want to
hurt, we don't want to hurt, but what's a positive for
Hawkins Kennedy? It's pain. Don't
be afraid to maybe trigger somebody's pain
or something with what's going on, but letting them know This
is a possibility. This is what I'm actually wanting. And
(31:33):
I'm not going to make it where you blow up where you're an eight,
nine, 10 out of 10, but where we may feel this, then
we're going to stop. Then we're going to stop. Um, also
when you get an answer, stop. Because
with an assessment, I have seen that they will just test, test, test, test,
test, test, test, test. You're
(31:55):
muddy. I tell them you muddy the waters. You have a
sheet of things and it's like, what are you even going
to do with this? We
don't know. So you have more questions
here than we got anything out of it. So once you get an answer, stop
(32:16):
Yeah, I think that's some really, really great advice for
our younger therapists. It's like, you know,
all those special tests just aren't all that special, right?
Yes. So I have a special place in my heart for special tests. I
would, I genuinely like a special test. And
I tell people that the special test can, can provide something,
(32:39):
um, you know, one cost effective. You
don't have to go to a big, you know, machine. Um, I've been trying
to research all these old tests and figure out what's, because
speaking of that, you know what the, uh, Mosley test was for originally?
That's what it was looking for. So they were looking at a radial nerve compression. And
(33:01):
then they kind of felt like, oh, it may kind of go over
to the tendonitis. But
I think often with some of the special tests that we kind of lose
sight of where they came from and what they were done. I also
speculate that I think people kind of haphazardly do them. So
they just kind of like, Oh yeah, we're going to throw the arm. Yeah, that's a positive. It's
(33:23):
like, did you stabilize? Did you put them in that position? Did
you hear, did you lead them with a question? Did you say, does
this hurt? And it's like, yeah, you just cranked their arm. Yeah, that hurt. Like
I've worked with somebody who is bad on that. That's
the first thing out of the mouth. Is this hurt? Don't lead
with that. What do you feel? But
(33:44):
I will say special tests can also be a nice thing as a test retest
so that you can, okay, we got this positive a
second ago. We did this treatment, retest this,
all of a sudden it's better. So no, it maybe wasn't. You
know, the Mosley went from being positive five
minutes ago, we did cervical retraction and now it's, it's negative. So
(34:06):
now, okay, now we confirm that there's possibly a cervical radiculopathy
Yeah. I mean, listen, I'm not saying not to use
them, but I'm just saying to your point, we don't need to
Yes. It's just, they're all there on in
(34:27):
You don't have to click off everything on the list. Like it's
fine. Not to mention you may have a really, really irritated patient.
right? And in many ways, um, irritated
mentally and irritated, like literally wreaking
some pain and havoc into their system a little bit. Um,
(34:50):
well, as we kind of start to wrap things up, what
What would you like the listeners to take away from
the conversation today around helping your
patients gain that independence and those soft skills and
the communication and all
those things that us more
(35:11):
seasoned PTs take for granted sometimes, I think?
I think always being willing and open to talk. That
can be challenging because our schedules
are full of patients, but I tell patients, I
know I threw a lot of information at you. I'm happy
to sit and answer any questions that you have. Send me a text, send
(35:35):
me an email, send, you know, um, write them down on
a piece of paper. When you come back in, while you're riding on the bike, I'll sit here and answer every single one
of them. Um, and I think people really appreciate
that. Um, because I've had patients that will
have called me years later. What was
that thing that you told me about? Um, and, and they,
(35:56):
they liked it, but did you know that Matt is going to tell me
a ton of information and even direct me
where to go find the information too. So I think
that is a huge, huge thing with
our patients. And I really feel like with our profession, like how we're going that
for many people. They just want a dialogue. Tell
(36:18):
me what to do. Tell me not what to do. Tell me what to do. Tell me what not
to do and walk with me through this. I don't have to do a ton of stuff
with it. You're already very active. You're already moving around. Yes. We're, we're, we're going
Yeah, and I think that's some really great advice for
any PT in any stage of their career. Now, where
(36:42):
can people find you? And again, make sure you mention
your Instagram page because it's really funny and
really entertaining, but also really informative as
Yes, I'm trying to be. So you can find me on Instagram at Matt underscore
PT underscore DIP underscore MDT.
(37:03):
I keep that. I lost a friend many years ago who helped
me get my diploma in it. So I keep that in his memory, but you can also find
me on TikTok and YouTube at Matt underscore
DPT. You can find me on there as well. Or
if you just go to the Instagram, you can find the link tree and you just have me
all on there. So I just try it. So especially on Instagram, I'm
(37:24):
a goofball and funny. I try to do that because life
is hard. We have such stressful jobs. We're doing so
much to help people. And if I can just make you smile for two
Yeah. I was, um, I especially chuckled at
the one post where it had like, you're,
(37:46):
you're demonstrating an exercise for a patient and you realize that
Oh yes. I'll have to say there's, that's
been kind of funny. So there's
one where I'm on that rocker board and it's like, when you're trying to
demonstrate exercise and it's like, you can't do it. I
(38:07):
have gotten so many comments. Those shoes I
was wearing, I just wore, I didn't mean to
wear those that day for that meme. I just, people
have come, it's because of the shoes, all you need to do. People
don't really like, I can do every single one of those exercises. I'm
like, I'm being funny. I'm
(38:27):
like, it took a lot more skill to do this incorrectly and
Yes. Then there was another one. It
was, it was, uh, like when you do an exercise and you're like trying to
hold your breath. Yeah. Like
(38:50):
you're trying to hold it in like that. You're not out of breath. Right.
Right. Right. Yeah. No, it's really, it's really funny there. It's
a really, really nicely curated, um, feed.
So I was, yes, I was chuckling. And then also the one where you're like,
um the patient left like you're running
(39:11):
and it's like the patient left you're running after a patient because you forgot
to do like that last assessment or something that was
my that's been my favorite one to make uh yeah it's when
it's when that person this used to happen so
they're walking out the door going i'm gonna go see the doctor right now and
it's like What? I didn't get any. I
(39:33):
got to send a progress note. And so that was been
the most fun one I've done. It was my wife driving
beside me in the car. Oh, I was wondering how you did that. We're
in a parking lot. I'm thinking there's probably people like, what are they doing out
(39:54):
I did get caught the other day. So that one I did about
like the last minute patient and just like looking. And I
was, I got in my truck and I rolled the window and I set my phone on somebody's
car. And as soon as I did, I might record their walked up and I'm like,
I'm making a video. You don't you don't mind, do you? I'm like, oh,
(40:16):
Well, just for everyone that's listening, we'll have all the links to all of
your social media in the show notes. So whatever platform you're
listening on right now, just scroll down a little bit and
one click will take you to Instagram and TikTok and YouTube. And
so, Matt, last question is when I ask everyone, knowing where
you are now in your life and career, what advice would you give to your 20 year
(40:38):
Um, I would say ask questions. Don't
be afraid to ask questions. I tell it to every PT student and all that
when you're young, when you're in that point, you can ask
the question and it doesn't make you look dumb. Ask,
you know, what does that mean? What does that do? And you'll
very often get somebody who's not upset, but
(40:59):
so happy to explain it to you. I have found
that has went so far, and I wish I had done that so much further. I'm
talking about if you do it with other therapists, you go meet
a physician, be your buddy for life. If you ask them,
why did you do that? I'm just kind of curious and they will love
you. But for anything, Hey, I just
(41:20):
want to ask you some questions about that. And that's what I really tell everyone. Hey,
if you just ask why you'll learn so much.
Oh, I love that. That's great advice. And again, especially
for our type APTs who are afraid to be wrong or who
don't want to look like the, the quote unquote, dumb one
in the room asking a question, because if you're wondering it,
(41:41):
there are other people who are wondering the same thing. They just don't have
All right. That reminds me when I played football years ago, my
coach said, if you miss a block, You know,
don't like get scared. He's like, if you're just going to miss a block, just
start hitting people. So it's like, if you're just going to mess up,
mess up big, don't like tiki, just mess up big. And
(42:03):
it's like, okay. Then we can fix it. Then we can,
what we did in the ago. So same thing. Just ask the question is
Great, great advice. I love it. Well, Matt,
thank you so much for taking the time out of your schedule for
coming on today. Great conversation. And
(42:23):
I just know all of our listeners are going to love it. So thank you so much.
My pleasure. And everyone, thanks so much for tuning in. Have
Hey everybody, welcome back to the Healthy, Wealthy, and Smart Podcast. And
today we're going to be talking all about how to build independence with
your therapist, why communication is so important, meeting
them where they're at, and to help on
this journey of patient empowerment. I'm
really happy to be joined by fellow physical therapist,
(00:24):
Matt Huey. He is an orthopedic PT
in Texas who loves not only helping people get better,
but entertaining people on social media, which we
will get to his Instagram towards the end of the podcast. But
I'll just say, check out his Instagram, Matt underscore PT, underscore
DIP, underscore MDT, because it really is a lot of
(00:46):
fun. And we'll talk a little bit about that later and the evolution of
that and um, how people can get in touch with you, but
It's a pleasure. Now, before we get into all of this patient empowerment,
can you give the listeners a little bit more about your
(01:08):
So I've been a physical therapist, uh, coming up on 15 years.
I've been in orthopedics the entire time outpatient orthopedics,
um, from Mississippi originally. So that's, um,
yeah, that's my accent. I'm in Texas. So I say, I say I have
a, a Southern accent, not a Texan ass accent. It's a
little bit different, but. Uh, say I became certified
(01:31):
in the McKinsey approach MDT back in
2013, then completed the diploma in 2020, no,
excuse me, 2018 fellow of the AOPT in
2020 and certified manual trigger point therapist. as
well. So I do a lot of manual stuff. I've always
(01:53):
really enjoyed that. Also, I've
really enjoyed the McKinsey approach, and that's been
the staple of how I work with patients, but
also educate them and get them moving. And
with all that being said, I tell people I'm probably the most educated hillbilly
(02:19):
It, it, you know, people, when they get
around me that are not from the South, they'll
say like, I noticed I have this little twang. I said, I think it's a sympathy thing that
people said that you kind of pick up a, an accent of people, whomever that
Yeah. Yeah. I remember when Madonna had that British accent when she
(02:40):
Oh, yes. Yes. There you go. Dating ourselves
I know. That's OK. The younger viewers
go look it up. You'll love it. OK, so
you've been a PT for 15 years, have a lot of advanced
training. How do you, before we get into some of
(03:00):
what I talked about in the intro, how do you feel
that the training you received better equipped you
So I really feel like it gives a deeper
way of explaining things to people, to
understand like what they have going on. And,
(03:22):
you know, we talked about empower and to say like doing this can
help you reach your goal. Uh, also like understanding
what is going on with somebody and feeling calmer when
somebody just starts, you know, we'll let you know. I just
had this patient today, and my neck's been hurting me on this
(03:44):
side, and it's going down my arm, it's up here, it's been in my
left side of my back, and down to my leg, and it hurts when I do this, and this, and this, and this. It's
been like this for years. I never get any relief. And
I've met people that hear that, and they're just like, oh my
gosh, what am I going to do? And then sitting there, it's like, okay, Let's
just take this a step at a time. We're going to, let's focus on
(04:05):
one thing. Let's talk about this. Let's dive into that. Let's go into
here. Okay. Now we can move to the next thing. So it feels like it's
a much more thorough process in assessing someone and
being able to hit the points and, and that there end
up leaving the situation that leaving the assessment or
leaving the evaluation. Like this person understands
(04:27):
me, what is going on. I feel confident in that they can help me.
Yeah, and I think if you can. really
hone in on those soft skills through advanced training,
then I think it's all worth it. Because I think a lot of people, certainly
in the physical therapy world, when we see those titles after
(04:48):
the name, we think, ah, they're a manual therapist. They just want to go in
and move people around and manipulate things. And they're
not doing all the other stuff. And
I think that's probably a bad preconceived notion.
One big thing that, uh, and I tell people, are you familiar with MDT? Okay.
So, you know, the, the classification system.
(05:11):
So if anyone is, if not familiar with MDT, um,
most people know about the classification, dysfunction, derangement, postural,
and other. Really what the diploma and
the fellowship, uh, helped me with is that other category.
Because if somebody comes in with back pain that responds to repeated
extension and lying. Just like, do we need
(05:34):
to spend more time working, teaching you what to do with that person? It's
that person that, um, it's like, I
tell it, I didn't tell like, this is the hard patient. I get this pain
on the side of my back, like left side of my back when
I'm brushing my teeth. Like, and it's like a three.
(05:54):
It doesn't bother me with anything else. Like, it's just like, it just right here. Or
like I put my contacts in or it teaches you
how to help that patient. Cause that one's a challenging one.
That one that just doesn't respond to like
repeated motions or just, it's just all over
the place. It helps you with those other, as we
(06:15):
classify them in the other category. So it really helps you
Yeah. Yeah. I mean, I'm not certified by any means
in MDT, but I do use the
evaluative procedures when
I have a patient who I might be seeing for a knee for knee
(06:37):
pain and comes in. Oh, you know, I just went on like
a longer hike and I'm not used to having this pain and it's kind of
radiating down into my glutes and maybe a little bit into my
you know, which I'm sure you get all the time. So I think it's really great
that you can use this framework in order to help those
patients who maybe have not gone on to see a doctor yet, or
(07:00):
you're seeing for one thing and they come in with something else and
you can give them your
best hypothesis as to what might be happening. And that can
Yeah, I also feel with some of the specialized training
that unfortunately, you know, you hear about patients
(07:22):
that failed therapy. All the patients, they failed therapy,
so they need it, or therapy didn't work. They needed the injection, they needed a surgeon, they
needed this stuff. But it's like, did they really fail
or was maybe the therapist wasn't the correct therapist
or they didn't explore this or explore that. And
it's like, it's not a fault of the therapist. Like I never say it's
(07:43):
not your fault. But I often look at some of the specialized
training, like with physicians, you have general practitioners and
you have specialists. And the general practitioners can help
people, and then sometimes they're like, no, no, no, no. This is not something
in my realm. Let me send you to this person over here. So that's what I
feel like it can help with those little things like that, where
(08:04):
someone else may say, this person failed therapy. They
need the next thing. When it's like, really? They didn't. They
need it a little bit more. You need it to look here. You need it
to push into that and to really see if
Yeah. I hate that term when people say, oh, they
failed at PT. It's
(08:27):
just, it's so like, what? Cause I've,
I remember I had a doctor refer patient. I'd like a
medium, I'd say maybe moderate rotator cuff tear. Okay.
You know, you can do exercises. You don't have
to have surgery for that, but the doctor's like, try PT for
a month. See if it helps. Oh,
(08:51):
PT for a month for a moderate like men to moderate rotator
cuff tear like how about PT for six months and
see if that helps right so so then you get the email well the PT
I've had that, which I've thought was very infuriating as
well. Somebody with back pain. I've got, you know, this person's 68 years
(09:14):
old, has back pain for 10 years, is incredibly
stiff, doesn't move. And they're like, yeah, you get a
two times three. It's like, do you remember
physiology? Like we don't even get a physiologic change
really in that short period of time. And
how can you say this did not work? So
(09:39):
I had this with a patient one time. He came
in and he had had a
previous rotator cuff surgery. And he told me, He said, well,
I don't think the therapy took. I'm like, what do you mean it took? Would
it take your keys, your wallet? What did it take? And he said,
well, it didn't really work. And I said, well, he was a teacher.
(10:01):
I said, OK, if you have a student that
fails, what's the first question you're going to ask that student? did
you do your homework? And what are you going to say when that student goes, well, no, no,
no, I paid attention in class, which is like the same thing as you. So
you didn't do the work on your own. So no, you didn't,
you have to keep, keep that up. And I would say that
(10:22):
with, you know, I apply a lot, use a lot of analogies and
I kind of use it for a lot of stuff to say like, When you get into shape, you
don't exercise and all that stuff for like a day until
people's like, you don't get up, run five miles, ate
a bowl of cereal. I had a salad for lunch and I went to the gym for an hour. I don't wake up
20 pounds lighter the next day. Does that say it didn't work? No. It's like, it
(10:42):
takes time. Same thing if you did that over six months. And
then all of a sudden you stop. Did you say like, no, no, no, the, the, you
know, the healthy eating and the exercise didn't work because it didn't stick. Like,
no, you have to keep some of this stuff up for a period of time. And
so that's what I really get into educating people about
to say, like, really give this a significant amount of time. And,
(11:05):
and really seeing early on, that's something I tell patients. I was like, I'll
be the first one to tell you this is not working. So.
Yeah. And that kind of gets into the bulk of
our conversation today, which is how to build that independence, excuse
me, how to build that independence with your patients. So
(11:26):
can you take us through how you
do that with your patients? Obviously knowing everyone's an
So really to start off, just the same thing
that we always talk about, listening to the person, validating
what they've got going on. So that just
(11:48):
really starts with it. you
know, the assessing their movement and then saying,
based upon what we may do, to
say, oh, you may have this or you may have this going on, but
let's try this to see if this gets you better. And
then while they're doing it, we may be explaining, I may start explaining
(12:11):
what's going on. So, if
somebody came, the most common thing I see is mechanical pain. So,
person, I explain, you know, we have different types of pain. We have an inflammatory pain,
visceral pain, a nerve root. So, we can have all
this type of pain, but you've probably felt mechanical pain before,
like when you sit too long. And then you get up, you start walking, and you're like, oh, it
(12:32):
feels better. That's really what we're doing. And
then you see, like, OK, well, what does this mean? Well,
what does that mean? You know, they said, well, they told me on the MRI that
it's bone on bone. It's like, well, you know, nobody stuck you with a dirty
needle and gave you that. You know, you were fine two weeks ago. This
came on yesterday. You just didn't get that to happen. You
(12:53):
know, that's something that is very, very common. If you want
to look up any research about it, yes, you will see all
of this. And so really just explaining a lot of that,
answering questions is a really, really big
thing. I am seeing a positive thing with
a lot of people now is they don't want
(13:15):
to turn out like their parents or grandparents. By
seeing them saying, um, I've seen what surgery does
to people. I've seen what all that medication does and
going from doctor, I do not want that. And so
they, they're seeing some of the negative aspects
of the more advanced procedures. And so they're, they're starting
(13:38):
to hold, I'm starting to see more, there's like, I don't want to, I don't want to
do that. Or they're coming in
very afraid that, I don't know
why that did that. I don't know why. That
thing just threw me off there. I know it was so funny. I was like, yeah, that
was weird. Um, but, um, they're, they're
(14:00):
afraid to say, well, I don't want that. I
don't want that surgery. Cause the doctor said that
I'm going to have a surgery and that's not what I want because I've
seen it and I'm, and they're scared. And so when you
start in just saying like, no, no, no, no, no, that's not what we're going for.
We're not trying to go. We're trying to avoid it, you know? And I tell them
(14:20):
if you need it. It, you know, we can hold on to it. We'll put
it in our back pocket. They'll do that surgery next week, next month,
next year, 10 year, they'll do it down the line. If you need it, we will
Yeah, so it sounds like you have a pretty systematic way
when you're evaluating your patients. And I assume when
(14:41):
you're reevaluating patients or, and I mean, I don't know
about you, but I'm sort of reevaluating at every session. Would
you say that you do have like a
generalized blueprint that you're following for each of these
Yes, so I tell everybody, I'm
going to ask you how you're feeling when you come back and you're going to
(15:04):
give me one of three answers. You're going to be better or worse or the same. I
said, if you're in all three of those, tell us
something. If you come back better and you're like, Oh, it feels better. Cool. Great.
We're doing the right thing. We're keep going that path. If you come in the same
and you did your stuff at home. Then
we weren't the, what we thought was not the correct
(15:25):
thing. We can move to the, you know, differentiating between hip SI and
lumbar. We took one off the table. Now we can really
focus on that. You come in worse, something changed, something
changed to make you worse. Now we can go from there. I said, the only
thing that, um, will tell
that won't help us is if you don't do anything. If you don't do, and
(15:46):
I had somebody did that one time, they had a neck pain. really
forward head. And when they came in the next visit, they
said, well, I'm the same. Did you do your exercise at home? Yeah,
like one, two, three, four, five. It didn't work. I had to quit. It's like, no, you
didn't do enough. So it's assessing, OK, how
are you feeling? What are you feeling? And assessing
(16:10):
one of those functional baselines that we may have asked is, how
is this or how is that? How is this? Can you get your
stuff in at home? Can you show me how you do them? Okay.
And if somebody's doing them, it kind of goes into like, all right, let's start moving
you a little bit more and just start doing this and start seeing it. So it is kind
of a, it is a systematic way of progressing people
(16:31):
kind of. And also I look at like stability of stuff is
how I call it. So like
we use the classification of derangement. So like if I have somebody with
a neck pain and I'm going to kind of look at how that
when they come in that next visit, if they're saying like, I'm feeling really,
really good. I may do a little bit of exercise, but
(16:52):
then tell them, I don't want you doing this at home. I want to see how you feel tonight,
tomorrow, the next day, because you may say, well, it felt great.
Then you wake up tomorrow going, oh, oh. So, so
And if someone is coming in, let's
say it's their second or third visit and you
(17:14):
ask them, how were the exercises? I didn't, I didn't have
time to do them. I'll be honest. I didn't do them at all. So
we all run into those patients. We do not want to dismiss
them. So what is your response to
a patient when they come back and say,
I didn't, I just, I didn't do them. I didn't have time. I didn't do
(17:35):
this. I didn't do that because that happens. And so
if we want to empower our patients to be part of
the rehab process, what do you, what is your
response to them? And what can you share for our listeners that
So I get into the why to say like, well, what happened
with it? Was it, was it too complicated? Was there something else
(17:58):
going on? That's one thing I do with my home exercise. I don't give
people a sheet of them. I don't give you like, I
knew somebody that would give people 12 exercises, two
sheets with 12 exercises total. I'm like, I'm not going
to give you all that. I tell them, I was like, I'm going to give you something simple
to do. And I just want to do this to
(18:21):
see what it does. And I let them know the complexity
is not in the simplicity. The complexity is in
the consistency. And so I set
that tone, but if they come in to say, Oh, I know I just didn't have time
to do it or not. Well, why not on
it? And, and just really kind of get their rationale to say,
(18:43):
well, you know, I didn't have anywhere to lay down. Okay. Can
we, can we modify, could, could we possibly modify that?
Uh, you know, all work was, was just crazy or had
this. And so maybe try to find some sort
of modification to them. Um, I
am, I do try to be honest with them as well. When somebody says
(19:05):
like, well, can we just do something different? It's like, well, you're not
going to get the same results. It's like, you're going
to, you're most likely going to get your best results with this. So
can we fit it in? Um, I've also started telling people to
take like schedule it, like put it on your
calendar, you know, and, and I try to keep, I try to keep stuff under
(19:28):
five minutes. You know, if like, if you're able
to just kind of dose it during the day, uh, that
works, but schedule it just like, Hey, I'm going to do this for
five minutes on it. Um, and set
a place, you know, don't do it in the
living room in front of the TV. My dad was bad about that. He
(19:49):
would try to do exercises sitting in his chair watching TV.
It's like, no, no, you go to a corner and that's
your corner. So that is your time, your place
to do this. So I'm going to focus and do my work here.
And really saying like, just spend that time. on
it and you're going to get a really good result when
(20:13):
you start doing that stuff. Um, I've even had people,
um, there's some, uh, medication apps. If you need reminders,
there's medication apps that you can have them download that.
They do your exercises here. It'll
send you a reminder to do your exercise. And I've done that for, I've done
(20:35):
Yeah, and I love the fact that you're not berating them.
You're not saying, oh, well, you know, if you don't do the exercise, you're never gonna
get better. But instead saying, getting to
the why, and then working together
as a team to figure out a way that
you can get these little snacks in during the day. And that
(20:58):
That's a big one. Um, really when people start returning back
to their normal function, I tell them, I'm
like, you're standing at brushing your teeth. You
You know, you're standing over here, grab this, you know, stretch it, throw
this little thing in, put 10 reps here, do 20 reps
(21:19):
here. You can throw these little things in through your
Yeah, absolutely. I always tell people like, you're not
doing all, you don't have to do all
the exercise at once, unless you want to, unless you want to say, I
put to your point, 30 minutes into my schedule, this is
when I'm going to do all my exercises. But with some people, like
(21:42):
I have people like, oh, if you're waiting for the subway, just
do some heel raises. Oh, you're waiting for the subway, go against the
wall and do some pelvic tilts against the wall. You know, so
there are a lot of ways that you can incorporate home exercise programs.
It can't just be a blanket. You can't give the same thing to every person
(22:04):
in the same position at the same intensity level, et
cetera, because what works for one is not going to work for
Yes. And I let people know because sometimes they're like,
well, I've done this before. And I'll say, yes,
some of these things are wonderful to be done across the board. And
so they're a very common thing that we are going to use. And so it's
(22:25):
like, yes, I may use the press up for, you
know, 70% of my back pain page, but it's like, it works for like 7% of them. So
it's like, Yeah, so
you've done that now I may change it up as well because that gets
into an explanation Because people are like oh when
I did therapy five years ago This was one of the things I did
(22:46):
and I just did three sets of ten So I'm just I'm gonna reference that
old one and do that same thing and explain. No. No, it's
it is the same I want you to do it way more frequently
and we're not gonna focus on the other things we're really gonna focus on this and And
so they, luckily, if they've done it before, they
kind of recognize the benefit. And then when you explain like, no, no, we're using
(23:08):
it in a different way than the, oh, okay. Okay.
Yeah. And I just think
that what you're talking about here is all about communication
and how to communicate things properly, how
to communicate things with some empathy, how to meet people where
they're at. And is there ever a danger of
(23:34):
I would say that there can be, um, I try not
to give too much because until,
you know, um, this reminds me, I had an anatomy teacher before I went to PT
school. He's like, the brain could only absorb what the behind could
withstand. So if people started getting fidgety, he would be like, our class is
over. We were so far behind in that class. But I don't
(23:56):
tell people that you know, you're coming in pain. You're probably not
gonna retain a lot You're probably gonna
is Adrian Lowe says people remember two things how you made him feel
or excuse me the last thing how do you make it feel and the last thing you
told him and so I You
know talked a lot and I said, I'm probably gonna give you too much
(24:16):
information. I If you ever have questions, write
it down, come back, send me an email, text me, and I
will do any of this and let them know. I'll clarify anything.
But going back to that point as well, I think that there can be times when giving
too much Uh, when people are very kind of
like hyper aware of it, like, you know, I got this back pain
(24:40):
and I heard that disc problems are like forever and you got
to do surgery and then you have to go to this. And it's like, okay,
I don't really want to talk a lot about disc
stuff or back stuff. I have to be very
careful in what I give them because they could take that and run
with it because they could soon as they, they walk out the door. It,
(25:02):
the, everything got twisted up in their mind. And oh my gosh, he just
said, you know, this is just going to be forever. You know, telling somebody like, you
know, if you have back pain, once you're at a, what, 80 some odd percent chance of
having it again. I had somebody that one time walked
out the door. He said, he said, I'm going to have back pain again in the future. I
was using it in a reference to something. So it is kind
(25:23):
of like, let me gauge what, how you are. We're just
And I think a lot of that, um, you become really much
better at it, the more you do it. And it isn't experiencing
the longer you're in practice, the better. So for all the physical
therapists out there listening, if you're on the younger side within the
(25:44):
profession, just know that communication and
reading people and having those soft skills and motivational interviewing,
right? Because you and what about the,
um, cause this is something I just said today, I think like
with two different patients, but I probably say it at least once a week, you
(26:06):
know, I'm not sure, but I'll get back to you. So
what are your thoughts on the, I don't know, versus saying
something that I mean, like if
you don't know, don't make something up. So what
I'll tell you, I'll sometimes have them ask, um,
(26:28):
you know, ask a question. I'm like, that's a good
question. I'm going to find that out for you. Luckily, like most
of them don't mind that you pull out your phone and look that up. And it's something like,
you know, let's, let's have a lesson together and
let's learn about that together. And so I, I
don't have a fear of it. I do have some patients,
(26:51):
long-term patients that come back. They're like, when you
get that stinking look, I know you're wondering and
thinking, and I know the answer is probably just not going to
be fun for me. But they recognize is like, you
may not know, but you're going to go look and you're going to come back and tell me so
built that rapport. And, you know, I tell them I will find that out.
(27:13):
And that's sometimes when they come in, guess what I'm going to
tell you right now, I'm telling you right off the bat that, that next
Yeah. And I think that's a really important lesson for PTs, especially younger
PTs, because in school we're taught to always
have the answer. Right. Yes. And
so when you get out and you start working with patients and you don't have the answer, the
(27:35):
temptation is to make something up to make it look like you have the answer, even though
you don't have the answer, which can be worse. So the
best thing you can do is, and it's not a weakness to
Yeah, and that will go over to something about treatment. I
had somebody taught me, they said, don't try
to treat something, understand it before
(27:58):
you try to treat it. And I think that even goes into treatment when somebody is
like, again, we may talk neck pain or back pain, and
it's like, I don't have a directional preference. I
don't know exactly what this person is going on, but let me just give them some
stuff to make them better that I think will make them
better. And I, and
(28:18):
I, and I had mentors to tell me, it's like, figure out what's going on.
And somebody like that, I've taught students, make
them worse, sit there and try to make them worse. Because
if you make them worse, you can make them better. And so if, if
somebody has a pain or something, it's like, I
don't know what is this is. I don't know if this is your neck or your shoulder
(28:39):
or is it thoracic or whatnot, but I'm going to pick your neck and I'm going to try
to make your neck worse. And if I could, and if, and I will let, but
that goes to a lot of explanation as well. Yeah. We're
going to do this. Now, if you start to feel X, Y, Z, and you
know, this and that, stop. Then we know
what is going on. If you don't have that, we took that, we
(29:00):
moved that off the table. We can go to that next thing. But it, but
it's telling somebody it's like, I'm not a hundred percent. I have a few ideas.
Let's test this one. Let's look at what we have here.
Let's really test it and thoroughly examine it to see, is
this the, you know, what it is rather than you spending our wheels
(29:20):
Yeah, absolutely. Honesty is
always the best policy. So oftentimes I'll
say to patients, well, I think we have a hypothesis.
of what's going on. And we're going to work off that hypothesis and
see how you react, because it could be this. It could be
this. These are my thoughts. And how do you feel about that?
(29:43):
And involving them in giving them some agency over
those decisions, I think also goes a long way to creating
independence. And what
other tips or tricks do you
have? And let's keep those younger therapists in mind right now. For
those younger therapists who are
(30:06):
starting their first job and they're overwhelmed and
now they know it's okay to say, I don't know. How
else would you advise those younger
therapists to help with building
independence with your patients and being someone's physical
(30:28):
I just build that rapport with them. Just chatting with
them, talking about it, get them just talking about whatever. Um, you
learn quite a lot. And that's a big, just, just listening and
just, you know, just, but they're spouting about
what they can't do or their job, their kids or things
that they're sport, whatever. And people tend to like that. And you
(30:50):
can also kind of get a lot of information out of them as well. Then
you can find out what they like doing. Okay, you
like doing that, maybe we can work into doing those things as
well. Also, again, kind of going
over back to what we said earlier with
the younger therapists, don't be afraid to trigger pain. Like we get
(31:11):
this whole thing We don't want to
hurt, we don't want to hurt, but what's a positive for
Hawkins Kennedy? It's pain. Don't
be afraid to maybe trigger somebody's pain
or something with what's going on, but letting them know This
is a possibility. This is what I'm actually wanting. And
(31:33):
I'm not going to make it where you blow up where you're an eight,
nine, 10 out of 10, but where we may feel this, then
we're going to stop. Then we're going to stop. Um, also
when you get an answer, stop. Because
with an assessment, I have seen that they will just test, test, test, test,
test, test, test, test. You're
(31:55):
muddy. I tell them you muddy the waters. You have a
sheet of things and it's like, what are you even going
to do with this? We
don't know. So you have more questions
here than we got anything out of it. So once you get an answer, stop
(32:16):
Yeah, I think that's some really, really great advice for
our younger therapists. It's like, you know,
all those special tests just aren't all that special, right?
Yes. So I have a special place in my heart for special tests. I
would, I genuinely like a special test. And
I tell people that the special test can, can provide something,
(32:39):
um, you know, one cost effective. You
don't have to go to a big, you know, machine. Um, I've been trying
to research all these old tests and figure out what's, because
speaking of that, you know what the, uh, Mosley test was for originally?
That's what it was looking for. So they were looking at a radial nerve compression. And
(33:01):
then they kind of felt like, oh, it may kind of go over
to the tendonitis. But
I think often with some of the special tests that we kind of lose
sight of where they came from and what they were done. I also
speculate that I think people kind of haphazardly do them. So
they just kind of like, Oh yeah, we're going to throw the arm. Yeah, that's a positive. It's
(33:23):
like, did you stabilize? Did you put them in that position? Did
you hear, did you lead them with a question? Did you say, does
this hurt? And it's like, yeah, you just cranked their arm. Yeah, that hurt. Like
I've worked with somebody who is bad on that. That's
the first thing out of the mouth. Is this hurt? Don't lead
with that. What do you feel? But
(33:44):
I will say special tests can also be a nice thing as a test retest
so that you can, okay, we got this positive a
second ago. We did this treatment, retest this,
all of a sudden it's better. So no, it maybe wasn't. You
know, the Mosley went from being positive five
minutes ago, we did cervical retraction and now it's, it's negative. So
(34:06):
now, okay, now we confirm that there's possibly a cervical radiculopathy
Yeah. I mean, listen, I'm not saying not to use
them, but I'm just saying to your point, we don't need to
Yes. It's just, they're all there on in
(34:27):
You don't have to click off everything on the list. Like it's
fine. Not to mention you may have a really, really irritated patient.
right? And in many ways, um, irritated
mentally and irritated, like literally wreaking
some pain and havoc into their system a little bit. Um,
(34:50):
well, as we kind of start to wrap things up, what
What would you like the listeners to take away from
the conversation today around helping your
patients gain that independence and those soft skills and
the communication and all
those things that us more
(35:11):
seasoned PTs take for granted sometimes, I think?
I think always being willing and open to talk. That
can be challenging because our schedules
are full of patients, but I tell patients, I
know I threw a lot of information at you. I'm happy
to sit and answer any questions that you have. Send me a text, send
(35:35):
me an email, send, you know, um, write them down on
a piece of paper. When you come back in, while you're riding on the bike, I'll sit here and answer every single one
of them. Um, and I think people really appreciate
that. Um, because I've had patients that will
have called me years later. What was
that thing that you told me about? Um, and, and they,
(35:56):
they liked it, but did you know that Matt is going to tell me
a ton of information and even direct me
where to go find the information too. So I think
that is a huge, huge thing with
our patients. And I really feel like with our profession, like how we're going that
for many people. They just want a dialogue. Tell
(36:18):
me what to do. Tell me not what to do. Tell me what to do. Tell me what not
to do and walk with me through this. I don't have to do a ton of stuff
with it. You're already very active. You're already moving around. Yes. We're, we're, we're going
Yeah, and I think that's some really great advice for
any PT in any stage of their career. Now, where
(36:42):
can people find you? And again, make sure you mention
your Instagram page because it's really funny and
really entertaining, but also really informative as
Yes, I'm trying to be. So you can find me on Instagram at Matt underscore
PT underscore DIP underscore MDT.
(37:03):
I keep that. I lost a friend many years ago who helped
me get my diploma in it. So I keep that in his memory, but you can also find
me on TikTok and YouTube at Matt underscore
DPT. You can find me on there as well. Or
if you just go to the Instagram, you can find the link tree and you just have me
all on there. So I just try it. So especially on Instagram, I'm
(37:24):
a goofball and funny. I try to do that because life
is hard. We have such stressful jobs. We're doing so
much to help people. And if I can just make you smile for two
Yeah. I was, um, I especially chuckled at
the one post where it had like, you're,
(37:46):
you're demonstrating an exercise for a patient and you realize that
Oh yes. I'll have to say there's, that's
been kind of funny. So there's
one where I'm on that rocker board and it's like, when you're trying to
demonstrate exercise and it's like, you can't do it. I
(38:07):
have gotten so many comments. Those shoes I
was wearing, I just wore, I didn't mean to
wear those that day for that meme. I just, people
have come, it's because of the shoes, all you need to do. People
don't really like, I can do every single one of those exercises. I'm
like, I'm being funny. I'm
(38:27):
like, it took a lot more skill to do this incorrectly and
Yes. Then there was another one. It
was, it was, uh, like when you do an exercise and you're like trying to
hold your breath. Yeah. Like
(38:50):
you're trying to hold it in like that. You're not out of breath. Right.
Right. Right. Yeah. No, it's really, it's really funny there. It's
a really, really nicely curated, um, feed.
So I was, yes, I was chuckling. And then also the one where you're like,
um the patient left like you're running
(39:11):
and it's like the patient left you're running after a patient because you forgot
to do like that last assessment or something that was
my that's been my favorite one to make uh yeah it's when
it's when that person this used to happen so
they're walking out the door going i'm gonna go see the doctor right now and
it's like What? I didn't get any. I
(39:33):
got to send a progress note. And so that was been
the most fun one I've done. It was my wife driving
beside me in the car. Oh, I was wondering how you did that. We're
in a parking lot. I'm thinking there's probably people like, what are they doing out
(39:54):
I did get caught the other day. So that one I did about
like the last minute patient and just like looking. And I
was, I got in my truck and I rolled the window and I set my phone on somebody's
car. And as soon as I did, I might record their walked up and I'm like,
I'm making a video. You don't you don't mind, do you? I'm like, oh,
(40:16):
Well, just for everyone that's listening, we'll have all the links to all of
your social media in the show notes. So whatever platform you're
listening on right now, just scroll down a little bit and
one click will take you to Instagram and TikTok and YouTube. And
so, Matt, last question is when I ask everyone, knowing where
you are now in your life and career, what advice would you give to your 20 year
(40:38):
Um, I would say ask questions. Don't
be afraid to ask questions. I tell it to every PT student and all that
when you're young, when you're in that point, you can ask
the question and it doesn't make you look dumb. Ask,
you know, what does that mean? What does that do? And you'll
very often get somebody who's not upset, but
(40:59):
so happy to explain it to you. I have found
that has went so far, and I wish I had done that so much further. I'm
talking about if you do it with other therapists, you go meet
a physician, be your buddy for life. If you ask them,
why did you do that? I'm just kind of curious and they will love
you. But for anything, Hey, I just
(41:20):
want to ask you some questions about that. And that's what I really tell everyone. Hey,
if you just ask why you'll learn so much.
Oh, I love that. That's great advice. And again, especially
for our type APTs who are afraid to be wrong or who
don't want to look like the, the quote unquote, dumb one
in the room asking a question, because if you're wondering it,
(41:41):
there are other people who are wondering the same thing. They just don't have
All right. That reminds me when I played football years ago, my
coach said, if you miss a block, You know,
don't like get scared. He's like, if you're just going to miss a block, just
start hitting people. So it's like, if you're just going to mess up,
mess up big, don't like tiki, just mess up big. And
(42:03):
it's like, okay. Then we can fix it. Then we can,
what we did in the ago. So same thing. Just ask the question is
Great, great advice. I love it. Well, Matt,
thank you so much for taking the time out of your schedule for
coming on today. Great conversation. And
(42:23):
I just know all of our listeners are going to love it. So thank you so much.
My pleasure. And everyone, thanks so much for tuning in. Have
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