August 21, 2025 • 47 mins
In this episode of the Healthy, Wealthy, and Smart Podcast, host Dr. Karen Litzy welcomes Tom Swales, a seasoned physiotherapist and strength coach with over 20 years of experience in injury prevention, rehabilitation, and performance optimization. Tom shares his journey into physical therapy, driven by his passion for sports and a personal experience with injury that motivated him to understand the human body. He discusses the mind-body connection in movement and healing, and how it plays a crucial role in engaging clients. As the creator of the Advanced Movement Therapist certification, Tom provides valuable insights for professionals looking to enhance client outcomes and focus on peak performance. Tune in for an inspiring conversation on the intersection of movement, healing, and professional growth in physical therapy.
Time Stamps:
[00:01:27] Passion for physical therapy journey.
[00:06:12] Understanding the human body.
[00:08:05] Neurological influence on movement.
[00:13:54] Nervous system's role in pain.
[00:16:46] Setting patient expectations.
[00:19:41] Mindfulness in chronic pain management.
[00:22:42] Self-assessments for progress tracking.
[00:26:30] Building resilience in chronic pain.
[00:30:12] Building resilience through small wins.
[00:34:20] Competing against yourself in workouts.
[00:36:19] Training for longevity vs. performance.
[00:40:52] Framework for effective clinical practice.
[00:45:19] Trust the process, be patient.
[00:00:00] Podcast introduction and gratitude.
More About Tom:
Tom Swales is a respected Physiotherapist and Strength Coach with over 20 years of experience in injury prevention, rehabilitation, and performance optimization. He created the Advanced Movement Therapist (AMT) Certification to help professionals enhance client outcomes by focusing on peak performance.
As the founder of COMPHYSIO+ Performance Wellness, Tom has worked with professional athletes and consults for Olympic and international sports organizations, making him an expert guest for health and performance-related podcasts.
Resources from this Episode:
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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. I
am your host, Dr. Karen Litzy, owner of Karen Litzy Physical Therapy
in New York City. And today we are
going to be talking about one of my favorite
topics, movement and healing, mind-body connection,
how to engage your clients. And I'm so
(00:24):
happy to have on the show a fellow physical therapist or physiotherapist. um,
for those who are outside of the United States. So
Tom swales is a respected physiotherapist and strength coach
with over 20 years of experience in injury prevention, rehabilitation,
and performance optimization. He created the advanced movement
(00:45):
therapist certification to help professionals enhance client
outcomes by focusing on peak performance as
the founder of comp 50 physio and
performance wellness. Tom has worked with professional athletes, consults
for Olympic and international sports organization, making
him a perfect expert for today's podcast.
(01:12):
So obviously I gave some of your highlights there during the
intro, but can you let the listeners know a little bit more about you,
how you got your start in physical therapy and kind
So I think most of us, we grow
up playing sports and we're always just like, I had a great experience with physio
(01:34):
or Cairo and I just had to become one. Me, because
I love my sport so much and when I got hurt, it frustrated me.
So I wanted to figure out how I could fix myself. So my self-indulgent
of learning about the body, human anatomy, how things
fix, how things repair, how they adapt, that
(01:56):
selfish endeavor kind of led into a natural interest in
all things pertaining to anatomy, human physiology, performance,
and optimization. And so it started in
high school. I got a soccer scholarship down
to the US, Graceland University. I'm an AT as
well. So I did the AT bachelors down there, came
(02:18):
back up, worked for a couple of years, got into the physiotherapy program, master's
program, which I barely got in. I applied
twice, didn't get in both times. And the
University of Western calls me. And they're like, hi, this is Donna
from Western. I was like, hi. She's like, so we got into a situation where
(02:38):
our first choices went somewhere else, and our second choices went
somewhere else, and your name is on the top of the rejection list.
Are you still interested in coming this September? And I said, so
Donna, you're telling me that I'm on the top of the shit pile, and you
want me to come to the PT program? She's like, yeah. I was
like, I'll see you in September. And then hung up, so they couldn't change their mind. got
(03:01):
into PT school, which is very difficult here in Canada, because there's only 12 schools. And
like, I, when I looked, you know, it's 335 schools
in the US at this point, there's still only 12 in Canada. And
so I got in, Got a degree, got
a job with the Canadian ski team, Olympic ski team, so having an AT background
(03:22):
as well as a snowboard mountain background, I
got recommended to work with the Olympic ski team. Did that for two
years, met my wife in the process of that. Once
I finished that, found my mentor, which is key if
you are looking to excel in this field, is
find that person that you want to learn
(03:43):
from that jives with you. So we can talk about that later. Learned
how, through his perspective of
a holistic approach to physiotherapy. He's a PT,
I think he was a dentist at one point, and he did acupuncture, traditional
Chinese, like he does everything, his whole office. Not just his
office, his whole clinic was his diplomas and degrees and
(04:05):
certificates all over the walls. I was like, this guy's unreal. And
his perspective on how to heal, he was
one of those people, he could put his hands on somebody and
he could see inside and then he knew exactly where
to go. He healed from what we
call, he healed from his heart. He was very empathetic and
(04:26):
very intuitive. I appreciated that, but
being a newer physio, I was like, I do not know what
you're talking about. And he would use all this language, and I was like, that sounds very
metaphysical, and I don't know what you're talking about, but I'll go
to that later. So I was like the movement guy. I was the mechanical, give
me the knees, give me the hips, give me everything. Almost
(04:46):
failed physio school because of neuro. And I said, once I pass that, I'm never touching that
again. And then later down the road, I started, you know,
once we opened up our own clinic, I started realizing everything's neuro. Yes,
everybody has a nervous system. Everybody has a nervous system and
everything is neuro until proven otherwise. So I started going
down that path to look at orthopedic problems. That
(05:07):
opened up a whole new world for me. And then I
started looking at, well, what composes the human being?
Like, if we were to distill it down, it's essentially psychology,
people come in with belief systems, right? Limiting beliefs that
we have to break. Understanding their nervous system. How is
the body responding to the inputs I'm applying or the words that I'm
(05:28):
saying? biology, chemistry, and physics. And then once I started studying physics,
especially quantum physics, I started to understand what my mentor was talking
about. So, you know, it's kind of tying it
all together. And looking at it through these five kind of
elements of the human being, now it broadened my understanding
of what we do as physical therapists, and then understanding what
(05:49):
we do, why we do it, and how we can do it better. So then, you know, you start building your
courses on top of that foundation, and then, you know, you can
create a system. It's that deeper understanding of how to help every
single individual human being. But to sum
it up, what's fun
about our profession is it's so vast. It's
(06:10):
so vast, it's hard to define what we do because we can do so many
things. So people are just like, well, what do physical and physiotherapists do?
And you're like, well, we do all this. So you're a chiropractor. Well, no, I do manipulation.
But, you know, I do soft tissue work. Oh, so you're a massage therapist? I'm like, no. I
also do acupuncture. Oh, you're an acupuncturist? No. Like, okay. Right? So.
(06:33):
And then when you blend those manual therapies and then you can bring in the movement
side, kettlebells, gymnastics, bodyweight training, Olympic
lifts, then you can really start to build a bigger picture and bridge
that gap between rehab and performance because really the same thing. So
I know this is a little bit of a long-winded answer, but we can kind
of diverge off of a couple of those topics. But I think
(06:54):
what drew me into physio is just this desire
to help myself, for one, but then this
deep interest in everything that has to do with the human body
and optimizing performance. And then when we had children,
it was like, how do I use some of these biohacks now to kind
of teach my clients how to improve recovery, performance, stay
(07:18):
kicking ass into older age? So I
think it's just fun. It's a fun profession because we get
Yeah, I couldn't agree more. And I
think you're right, the great part about our profession is
it is so vast and diverse and there's so many directions one
can go in. But I want to touch
(07:40):
back to something that you'd said during that, and
that's the influence of the neurological system.
Can you talk a little bit more about that neurological influence
on movement and pain and why that's one of the foundations of
your, when you are looking at a patient, a
(08:05):
So if we distill down what the nervous system's primary job
is, it's survival. Survival of the individual, survival of the species. So
now we have, okay, when someone's in a survival state,
what state are they in? Well, they're in a sympathetic state. Okay, so
now they're either in parasympathetic or sympathetic. When they're injured, when
they have pain, when mindset's not right,
(08:26):
they're in a sympathetic fight or flight. There's no healing, there's no change that happens there.
So I need to do things, I need to say things in order
to get them out of that sympathetic fight or flight. Simply by
being present, simply by asking questions, getting them to tell their story,
because oftentimes they don't get that time, they
(08:46):
automatically start to downregulate because they felt
hurt. So now I've created this connection, I've
created trust, and I've created safety in my presence. Now
that I've affected them psychologically, their nervous system
will start to calm down. Now everything I do from a
movement or manual perspective, the nervous system is going to let me in. So
(09:07):
I realized, okay, when I was younger, I was so eager
to be like, as soon as I asked a couple of questions, I know your diagnosis. And
you cut them off and you start, all right, let me go test the knee. Let me go test the
shoulder. But their body guards. And then you do manual therapy.
It didn't change. Well, because I didn't listen
enough. I didn't ask enough questions. I didn't dive into their longer
(09:27):
history of trauma, right? Like, you know, oh, that
new low back issue was from a whiplash 20 years ago. And
you still can't turn your neck. Well, I don't have pain there, but you've created compensations other
places. So, Once
we start to see the nervous system controls everything and
is the pathway of communication in
(09:48):
the body, if I know
that it's kind of a go-no-go system, if I apply an
input, say touch or modality or
stretch, If I apply it in the right spot, the nervous
system calms down, it reorganizes the system, and all
of a sudden range of motion improves. If I don't treat the right area,
(10:09):
no change happens. If I treat the wrong area, the
body guards more. So now you can use the nervous system as
a form of communication to know if you're moving in the right direction. Am
I treating the right spot? Am I treating what's priority? So
another thing that when we look at how we
developed just embryologically, when you look at the germ layers,
(10:32):
when you look at the order, what's at the center, typically
Sorry, just start where it
(10:53):
has like, because it just kind of froze up for a second. So
start back with what, yeah,
So if we look at simply how we were designed from an embryological
perspective, we're just a series of tubes and wires, right?
Everything is moving up and down. And if we kink
(11:15):
the hose or we compress the tube on one end, it will create
disruption or compensations at the other end. And
that makes it a little bit simpler as to, OK, well, yeah, you have this new back
pain, but I'm more interested in the old whiplash. We need to clean that
up first, because that's the thing that is causing all these
compensations in this new pain problem. Now, if I treat that
(11:35):
and all of a sudden I treat the neck and now they can touch their toes. They're
like, oh, oh my God, my back pain's like 80% better.
Well, it's like, because it was the neck that was driving it. But the neck is more important than
your lower back to the brain. Why? Because it's closer to the brain. So there's a priority of
structures, right? You got things that take up the most amount of energy, brain,
eyes, anything centrally, vestibular apparatus that controls everything.
(11:59):
So if there's old concussions, you gotta make sure that they're clear because if
you've got a cerebellum firing up on one side differently than the other, it's gonna cause orthopedic problems
on one side, overuse. So the
nervous system is super fun because when you
treat the right area, things just move
really quickly. Things unlock because the nervous system is like,
(12:21):
oh, thank you. I will let this go now. It feels safe. But
if we don't treat the right area, we're chasing pain, which is what we
can get caught doing. You know, they might have some temporary relief because
we changed how things felt around the joint, but then it comes back, right?
Well, did you clear the neck? Did you look at nerve mobility? Did
you look at the myotomes, right? Maybe there's some nerve stuff there first that's
(12:43):
tightening the muscles. And people
come in, they're like, well, my pec is tight, my hamstrings are tight. Oftentimes
it's nerve issues. Like 90% of
the time, there's some kind of neural restriction. And
if the nerves aren't sliding and gliding, if there's compression or tension
on one end, the nerves tell
(13:05):
the muscles to tighten up. Muscles are dumb. They only
do what the brain tells them to do. This is what I tell my clients. So before
I stretch and release this muscle, we need to find out why is
it turned on? Is it compensating? Is it protecting? Or
is it trying to stabilize something? Because if I don't find out what it's
compensating for, and we go and release or stretch it, it might make
(13:26):
things worse. We might have just taken away some protection, and all of a sudden, now
we've got an exposed hot nerve root. We shouldn't have released the peck in the upper
trap by needling it. Maybe we should have looked at neck stability first or
breathing or the diaphragm or something else. So when
we know how to talk to the person's nervous system and
use movement as our feedback loop to know if we're moving in the right direction, it
(13:49):
makes it a lot easier for us from an orthopedic perspective. So
that's why I love the nervous system because You look at
it first. Look at it first and a lot of the orthopedic problems go away because
what transmits pain? Nerves. Where's pain interpreted? At the brain. So
why not look at those more important structures before kind of all these peripheral, less
(14:09):
relevant structures such as muscles and joints for survival? If
we tear a nerve, we're in trouble. The body will be happy to
tear a muscle before it tears a nerve. That's why
you stretch, all of a sudden it tears your bicep off. Well, the bicep tear
stopped you from taking that median nerve into end range to possibly cause
(14:30):
Right. And I think it's also important as for people
maybe who aren't in the physical therapy world, that when
you're talking about making a difference to the nervous system, this doesn't happen in
one session, necessarily. This is something that it
happens over time. And there are also
those people, even if you speak with them and you create a
(14:52):
good rapport, it may take several sessions for
them to trust you. So if you're a new therapist and
you're like, well, I heard this guy in the podcast and he says, you
know, once they trust you, then everything poof gets better. And
it's like, well, hold on a second. We have to remember that
some of this is obviously dependent. It's on the patient.
(15:14):
And often this takes time, you
know, and sometimes the patient has that
sort of light bulb moment where they are
like, Oh, wait a second. The therapist said this might happen or
yeah, I am feeling what the therapist said may happen. And
so that's where the trust may come in. It might not even be in an interaction
(15:38):
Yeah, and that's part of the initial process of setting expectations.
Hey, you know what? We're going to get this shoulder to move a little bit better
because we're going to do some nerve flossing, or I might manip your T-spine to
get that to open up, to release this. But because you
haven't moved in that position for so long, it might be a little bit more sore for about
24 to 48 hours. because there's new inputs coming in, right?
(15:59):
There's new positions. And the nervous system and the brain might be interpreting this
new range of motion as, ooh, this doesn't feel safe. I'm not used to this. So
let's create a little bit of a panic signal here for
a little bit until things start to normalize or
find its new equilibrium. But that's also why it's so important as
therapists that when we do some kind of manual intervention, when
(16:21):
we do resets, that we apply
a movement or exercise on top of that to maintain it. Because if
we just crack something or needle something or stretch something and they walk away,
software hasn't changed. So they're going to revert back and in 48 hours, it
feels the same or maybe worse. So that's
why it's so important that we blend and we apply the right exercises
(16:46):
And I think you said something really important there, and that's about setting expectations,
which oftentimes we don't
do. I'm still guilty of that. I've been practicing for over
20 years, and sometimes I forget to set that expectation for
the patient. But in your experience
in over the 20 years that you've been a therapist, how
(17:10):
has setting expectations changed your
Well, I get a lot less emails and phone calls the
next day saying, you hurt me. Why am I so sore? Well,
we talked about this, right? And
it happens far less. And if they're
(17:31):
aware that something kind of not adverse, but
an increased level of discomfort wasn't
explained to them, then they're going to think, well, you
made me worse. I don't trust you. So now you've broken trust. And
it was simply because expectations weren't set. We didn't educate
the client on, hey, just so you know, you might
(17:53):
have a little bit of a flare up just because the body's going
to be moving in a different way it's not used to. If I don't say that,
now we've kind of fallen backwards in the trust. And it's
going to take a couple more appointments to build that back up.
So I'd rather not break that and just set the expectations up
front. But this is where the
(18:14):
longer we've been doing this, that communication part early on
is so critical. And spending more time talking
to the patient, if that's what they need and they need to tell
their story, that's fine. We do our assessments. I've
had patients sit there and talk for 40 minutes because on their intake
form, one of the things they didn't like about their last clinician, they
(18:36):
didn't feel heard. So guess what I'm going to do? I'm going to
give them more time, right? Didn't explain this.
Great. I know what you don't like, so now I'm going to do better.
So once they've been heard and I'm giving
them what they need, well now there's greater trust. If
there's greater trust, there's greater safety. Well, if there's greater safety, nervous
(18:58):
system calms down. Great, now that we're in this receptive state,
I can make changes to your physical body. Your biology, chemistry
will follow along with it. But it's all controlled by the nervous
system and the emotional state. Because at the end of the day,
all people care about is how they feel and how you make them feel. And
if they don't feel safe in our presence, they're not
(19:18):
coming back no matter how good you are. You can be the most technically sound
therapist, but if you can't connect with them and they
Yeah, there's no question. And that kind of
leads into, especially
for our more chronic pain patients, that
(19:41):
kind of mindfulness and awareness, self-awareness of
the patient and mindfulness of the patient. So how
do you help with the application maybe of
mindfulness techniques with your patients? And have you
I think it just starts with, during the assessment,
(20:04):
we set a movement baseline. Okay, you notice how that shoulder's 120? Yeah,
okay, great. We make them aware. We point out how
they're moving or how they're not moving. What parts are moving differently? Oh, see
your straight leg raise? It's like 45 on the right, but it's 80 on the left. Okay, we're gonna remember
that. See how your toe touch? you know, you're at mid-shin, we're
going to remember that. So now we've set a baseline for where they are starting.
(20:27):
Once we start doing the interventions, once we start kind of looking at
where their linchpins are and start unwinding and reorganizing the body,
we go back and check. Now their toe touches, you
know, two inches from the ground, or maybe they're touching the ground. Maybe their
shoulder flexion is completely restored, right? Hey, what's
going on there? Oh, wow, that feels better. Yeah. So it's
(20:48):
making them aware of what they're doing and not doing, and then showing them
the changes that are being made. Because at the end of the day, the
only thing they care about are results. And if you can show them
results quickly, even if it's temporary, which sometimes
it is, because if it's been longer standing, it's gonna take
a little bit more time to develop new movement pathways,
(21:09):
but at least show them in that moment that, hey,
look, we've got increase, we've got 50% more
range of motion. Oh, wow, look, you can reach above your head now
without pain, cool. So it's making them aware of
where they are, and then where they end
up becoming after interventions have been made. You're
(21:30):
like, okay, well, range of motion is here now. It might revert back, but
we're going to keep track of this. And you're also going to keep track of,
oh, well, you couldn't reach up into the cupboard, but now you can without pain.
because we want to create meaningful change. They don't care
if they have 170 degrees shoulder flexion from 150. They
don't care. But if they can reach up into a cupboard and grab a teacup without
(21:52):
pain, that means something. If they can bend over, pick up a
shoe without their back hurting, that's a win for them.
So it's giving them kind of baselines And
then, Hey, I want you to pay attention to how much easier
these things that we talked about earlier that are important to you, how much different
(22:13):
Yeah. So it sounds like you're setting up for them individual self-assessments
that they can do on a regular basis to
kind of check in with themselves and see where they are. Because I know
a lot of times as people progress through, they don't
realize the progress that they're
making. And so to create these little
(22:35):
kind of mini self-assessments at home is a really great idea.
Yep. Something as simple like in the AMT system, we
do what's called a global movement scan with everybody. And we do it every
single appointment just to kind of set a baseline because it changes. Flexion, extension,
rotation, side bend. Can you touch your toes? Can you back bend?
(22:57):
Can you rotate? Does it feel different right or left? Can you stand on one
leg? Can you side bend? Can you squat? Right? Very simple. And
you pick off the movement that's kind of the most restricted, see if
you can change that, and then recheck it. And if
they see a massive change, you're like, great, this is your home test. When
you feel that low back tightness or that groin pain again from sitting too
(23:18):
long, you're going to do your global rotation or your global extension
up against the wall. If it's restricted, you
go do your exercises, and then you check your
work to see if it changed. If it did, great. If it didn't, okay,
try these other ones. It's kind of like finding a lock and key system
sometimes. It's trying to figure out how the
(23:39):
nervous system is organizing the structure, and then find
those main linchpins to kind of get the body to
move a little bit differently. And oftentimes, the first couple of exercises you give
them, as long as your assessment is very thorough and you're
treating the right area, very simple. But
a lot of the times, where the importance is on the assessment. I
(24:01):
think clinicians, we get too eager into treating stuff And
we don't spend enough time on the assessment to gather all the data to
treat one area. Especially when somebody's got
chronic pain, you don't want to over-treat. Spend the time on
the assessment. We know, you
know, people in chronic pain, the assessment's pretty exhausting for
(24:23):
a lot of them. They're like, okay, cool. I'm just going to
treat this one spot. And it might be some gentle myofascial, some
visceral stuff, right? Some breath work on top of it. If
it's shoulder issues, you know, supine line, we're going to release the diaphragm. You're
going to do some shoulder, whatever it is. something to
kind of get, keep them calm. And then one thing for them to do at
(24:43):
home, because if they're an individual who doesn't do exercise,
do you think they're going to do the four or five exercises? No,
Three max. Otherwise you give four, they won't
(25:05):
you know, or less that people are like, yeah, I can handle that. I
can probably do that on my own. Right. Um, and again,
you can get a sense of that in your evaluation
for sure. You know, like I've definitely had people who I've
seen the first time and they're like, give me six
exercises. I will do them exactly. How's you, how
(25:30):
You know, but I usually wait for people to like explicitly
say that to me because usually I'm like, oh, I don't know. They won't
do it. But there are certain people out there who will. So
there are like, yes, I have this three exercise max
as a flexible rule. But of course, there are people on
either side of the bell curve that, you know, some maybe
(25:53):
Maybe it's to your point. Maybe it's just being aware of their posture
Let's just breathe in the right spot, right? Yes. Where
are you breathing? Oh, well, you don't have any breath. You're breathing up into here. Do you have any breaths
you take in a day? About 24,000. How about we just breathe every hour, put
one hand on your chest, one hand on your belly and just breathe into your belly. That's it. And then
(26:16):
just do some neck rotations or some eye exercises, right? To
kind of stack some neuro stuff on there. Like that's
oftentimes what some people need. They need to just be heard and then they just
need to do a couple of little breathing exercises and all of a sudden they're like, Oh my God, my shoulder feels a
Right. And, and how do you work on
resilience with your patients? Cause we've all
(26:38):
had people who are a little, have a little more complicated history,
complicated injuries, chronic pain, where their
capacity is really low. Um, and
they feel like they've seen 500 doctors and 40 physical
therapists and they've done all the things, nothing works. So, How
do you help those people build up their resilience
(27:02):
and build their capacity to accept whatever
the treatment may be? Maybe it's soft tissue work. Some
people don't, I don't like to be touched. I don't like to have anybody touch
me. And I have a history of chronic pain. And
Like, no, give me something else to do. I'll
(27:25):
do it. I'm one of those people. Give me six things to do. I'll do it. Do
Right. Yeah. So. If
people are in an exhaustive state, it
comes back to, you know, you can't prescribe, I need you
to do three sets of 10. Like that doesn't work. Especially
when we're trying to, we got to think of movement as a skill. Yeah. No,
(27:47):
it's not an Olympic snatch where you do one to three reps and
you got to make sure it's perfect. No, you're going to lay on the floor and you're going
to do 10 perfect breaths. Or you're going to do five
dead bugs or whatever it is, right? You get them to feel the right
position. You get them to feel where the breathing's going. And
then, you know, if I do have to give them some little bit of dead bugs,
(28:07):
give them a spine supported position to feel that cross cord reflex or whatever it is,
I said, it might be four reps. It might be 20. Until
you cannot feel the right muscles, keep the right position, if
you feel a pinch in your lower back or you hold your breath, practice is
over. I said, it might be four, it might be 40 reps. I
don't know. But you're going to do the reps. Some days
(28:29):
are going to be better than others. Depends on your sleep, depends on your stress, depends on
whatever. Exercise is stress. Why would I add more
stress to your system if you can't manage it? So we always
want to stop. Let's just say, we'll keep two in the tank. right?
Keep a reserve. You want to work to 80%, but
never to a hundred because as soon as you get to a hundred, you exhaust the system,
(28:51):
regardless of the complexity of the exercise. It all depends on
their threshold. So if laying on the ground and
doing six dead bugs causes them to fatigue out, they
do four and then they go do whatever else
they need to do for the rest of that day. And then maybe in another hour, you
do four more. right? It's like trying to progress your
pull-ups. Well, if you can only do five pull-ups, but you want to
(29:14):
get to 20, you go up to the bar, you
know, 10 times a day and you do two. Right?
You build those perfect repetitions. That builds the neurological framework.
That builds the myelin. That builds those patterns. And when you do
it precisely every single time, the nervous system gets more efficient. So
now when you step up to the bar in a month or
(29:35):
so, you can do 20 pull-ups. But you never train for
20. You just got the volume and the perfect practice in over time. It's the same thing
with rehab. This is where when we look at performance
and rehab, it's the same spectrum. It's just different ends. And
that's depending on the individual. But it depends on what the individual needs.
So to build that resiliency, it's just stay away from fatigue, stay
(29:57):
away from pain, make sure you can feel the right muscles doing the right
jobs, you're breathing properly, and
everything feels like it's supposed to, like we did it in the office. If
it feels different than that, you're done. Go do something else.
Yeah, so it sounds like giving people those little
wins throughout the day will help build resilience, help build confidence
(30:20):
versus to your point, like do three sets
of 10 or three sets of 15 or whatever it may be. If
that person is not ready for that and by the
end of the first set, there are forms all over the place, forget
It's dosing them to feel good. The
(30:40):
mindset of a lot of people is just like, I got to go to the gym and I got to punish myself.
They're a sweaty mess on the floor. They can barely walk. I'm
like, you know you have to do other stuff during the day. Well,
I have a goal. I'm like, okay, cool. You can mentally push yourself through
that for a period of time. I would say eight months before
(31:00):
your nervous system finds every reason not to do this. If
you leave the gym feeling terrible every time, subconsciously, your
brain's going to be like, you know what? I got to drive the kids here. I
really need the rest. You're going to make excuses. If you
leave the gym feeling great every single time, you're training your
nervous system to be like, I want that feeling again. I'm going to show up again tomorrow.
(31:22):
But it's the dose. It's just like manual therapy. It's like
anything. You dose it too much, cause a flare up. You dose it
too little, no adaptation. You dose it just right, that's
the Goldilocks zone. That has to do with manual therapy, movement therapy, training,
rehab, whatever it is. You find that Goldilocks zone of feeling good
and your nervous system switches on, you got more energy, that's it. That's
(31:45):
Yeah. I experienced that the other day. I started taking
Pilates classes again and were
on on a reformer. So, the teacher like
okay three springs everyone I was like, because I
know if I use three springs my forms not going to be good.
So I use two and a half she goes, are you doing two and a half for
(32:07):
a reason I was like, yes. because I want to make sure that I
have really good form. And if I do three, maybe
I can do two repetitions, but then I'm done if
I use two or and I'll keep going with bad form.
Right. So it's like I would much rather lower
the intensity and keep the form. And
(32:30):
to your point, I walked out. I was like, I feel pretty good versus, oh,
my back is sore because I had too much weight on
there. And I don't know what I was thinking. Right. So I'm
even me as a therapist doing this for over 20 years
as well. I have to continuously remind myself to
(32:50):
kind of stay in that Goldilocks zone. And then of course,
you know, as a physical therapist, I'm sure you've done this, you've gone to classes and
you look around and you're like, Oh no, that's
why I don't go to, I don't go to classes for that reason. Oh no, no,
that form is terrible. And look what's happening here. You
know? So I'm like, Oh no, no, no, no, no. It's like, you just
(33:10):
want to go around to everyone and be like, you can use less. It's okay.
I stopped going to a public gyms. Oh,
I just, you know, I have a, I have a, I have a gym in
my garage. I got my kettlebells, my Olympic rings I have
outside of my backyard. I have high bars and dip bars and you
(33:33):
don't need much, you know, kettlebells and calisthenics is primarily, I'll get under
the barbell at my office, but like at our facility, we have
a big performance facility side thing. So if I want
to use a hex bar or barbell, I'll go and do that once a week. But,
Yeah, for that reason, I can't do the
local gyms. It's just like put blinders on. I'm like, oh,
(33:54):
I want to help you, but I don't want to be that guy telling everybody. It's
out of like, I don't want you to hurt yourself, but that's not how it's going
to be received. And then your other point to doing
classes, if you're in a class where you're kind of competing against
yourself, but you're doing it next to somebody else, you're not
(34:14):
No, you know something, I have been able to really take
So I've been doing classes for so long that I am just
focused on myself. I don't even, like, sometimes
I'll look and just be like, oh boy, that form is
not good. But I am just, I
(34:36):
really try and focus on just what I'm doing and try and do better
in this class than maybe I did the one before. But,
you know, with age comes wisdom, as they say. So my
wisdom now is like, I am not I don't care what
the person next to me is doing. I don't care where their heart rate is
or how fast they're running or none of it. Yeah, none
(34:57):
of it. As a matter of fact, I was at the gym maybe two months ago and
I was sort of run walking on the treadmill and there was a woman next
to me and she was walking and all of a sudden she started running and she was walking. And
when we were like I was cooling down, she leans over, she goes, thank
you. I was like, for what? She's like, you were running. So then I said, you
(35:18):
But I, yeah, but I was like, oh, you're welcome. Like I didn't, I
knew she was running, but I didn't realize like the effect that,
you know, the person next to you has. So, you
know, but yeah, I've, I've tried to kind of block that out.
Well, energy feeds energy, right? Somebody
(35:40):
who's got higher energy in the room, you want to match that because it's
exciting. You can feed off that. You're in a high-energy room, you
get elevated. You go into a low-energy room, it sucks it out of you. That's
why being around people is so awesome, but
it can also be so detrimental. But we also have
to realize all we should be doing better is
(36:01):
than our former self. So I want to do one more rep better
than yesterday. I want to do one more pound better than
last. It's a journey. If we're looking for an end
goal, well, what's the end goal of human beings? Death. So
let's not race to the grave, but if we're
constantly hurting ourselves, and we can't train, we're
(36:23):
supposed to train for, at this point, longevity, unless we're doing some
kind of high performance thing. Which again, high performance, different
from longevity, it's pushing the limits, it's always on the threshold of injury, it's always
on the threshold of illness, different
than from longevity. So, what's the
rush? What are we chasing after? Unless you have some specific goal,
(36:45):
at the end of the day, make it feel good. Make it so that you want
Yeah, and I think that's great advice, again, setting those
expectations for our patients or our clients, because
it doesn't matter how old, I mean, I have patients who are in their
80s who are going to classes. So it doesn't matter how
old the patient is, but it is really important to set
(37:08):
those expectations and get them into the
Yeah, because you want to show up, the goal is to show up at class the next
That's right. Yeah, that's right. Okay. I
could talk about this all day, but let's talk a little
bit about the advanced movement therapist certification. Can
(37:31):
you let, like, what is it? What does it entail? Go ahead.
It's a framework built on those fundamental principles that I mentioned earlier.
Yeah. So psychology, neurology, biology, chemistry, and physics. And
I talk about those in a presentation I do. I don't talk about
it too much in the course because I want it to be very tactical and
(37:53):
applicable. And the five elements are
more kind of the philosophy behind it, right? We talked about
creating connection with neurology, movement. Biology,
how the cells are adapting to tissues, all that stuff. And then the framework
is, you know, how did we learn to move when we came into this
world? It's from the ground up. How are we
(38:15):
organized and structured from the top down? Once we
started to learn how to move and control our
center, well, we learned and we start to build movement from
spine supported, suspended and stacked, right? And then
we start to load it, then we start to create propulsion. So
once we start to realize the organization or the order in which we learned how
(38:36):
to move, we can often just go back down to one of those earlier stages
and clean up some movement patterns. And all of a sudden this more advanced pattern
over here is a little bit easier. The idea behind
it is to really simplify going
through an algorithm. Like every time we assess, We
have a set process, and we go through it. As a veteran
(38:59):
clinician, we should, at this point, have our checklist. Oh,
hit this crossroad. Let's diverge and let's check this
over here. Okay, that's clear. Let's go back onto the main highway. But
when we come out of physio school, they don't teach us that. They throw all
the information at us, at least here in Canada and from what
I've talked to in the US with some physical therapists. So
(39:21):
we learn how to assess the shoulder, all the parts, the pieces, diagnosis, all
that stuff. We learn how to treat the shoulder, right? And then we move
on to the hip, and then we move on to the spine. Like, they teach all the parts,
but they don't teach us how to assess the body as a system first, to see
where some of the restrictions are, to assess kind
of an order of priority, nervous system, for example. Maybe
(39:42):
you look at neural tissues before you look at muscles and joints. Um,
and then once, once you start to see, well, your rotation isn't really good to
the left, let's look at your T spine. Let's look at your hips. Let's look at all the joints that
rotate that may be kind of blocking that rotation. All right, great.
Now that we see that you can't actively and passively do this, let's
do our muscle testing. Let's do some myotoma. Let's do some, uh, muscle
(40:03):
testing, resisted range of motion. Let's look at all the parts and the pieces, right?
Once you start looking at the system and then pieces, then you start to see, Oh,
these pieces over here. Gotta love them, aren't
moving. So now we're like, well, if we can't rotate through the
T-spine, you might be rotating a little bit too much into your lower back, causing
some compression on that side, which is then causing the neural compression and
(40:26):
some of that straight leg raise or that sciatic nerve problem. Well, let's
just restore the T-spine rotation with some breath work, some rib mobs.
Maybe it needs a manipulation, do some rib lifts, whatever. Now, all of
a sudden, low back pain goes away. Well, it's because we redistributed forces
across the body. And then once we've kind of reintegrated
the parts, now we put it back into the system. So
(40:48):
it really simplifies the process, but it's a
roadmap as to, okay, great, we have an ACL, we
have a hip impingement, we have this. It doesn't matter what the injury is, go
through your checklist, go through all the parts and the pieces, go
through the order of the system. It will show you exactly where the
restrictions are. and it makes it so much easier. So I
(41:08):
created this one for the new grad to increase effectiveness quickly,
to utilize the information that we have out of school,
organize it into a very useful format. The
veteran clinician, which I became frustrated because these
are all me, You take 100 plus courses. It
(41:29):
becomes flavor of the month. You're like, all right, needling. Everyone gets needling this month.
Oh, that doesn't work. Everyone gets myofascial release. Oh, everyone gets manipulation. It
became that. And then you're like, I don't know what works for anything. So
you have all these tools. What it does is it organizes your
tools. right? It tells you, it gets, you get to this roadblock and
you're like, Oh, I got to go after a joint restriction for the hip. Great. Let's do some
(41:50):
needling. Let's do some mobilization with movements. Let's do some hip
90 nineties. So you start to learn how to deploy the
right tools at the right time for the right person, for the right purpose. And
then as the clinic owner, You can't see all
the people, and the point of running a clinic is, well,
you hire staff to help more people. Well,
(42:13):
you can't replicate yourself, but the easiest way to do that is create a system and
take what's in your brain, take that algorithm and structure, and
teach those around you. So now you can systematize and operationalize results
across clinicians. New grad, veteran clinician, doesn't
matter. Everybody's effective. Everyone's speaking the same language. Now,
I'm not saying that everybody thinks in the same way. I want them to go
(42:34):
out and do different courses, get different tools, get different lenses, but
plug it into the framework. The difference between the AMT
and a lot of other courses, this is a framework to build knowledge
and organize what you have, so you can be more effective with
what you have, regardless of how much you have. Because everything
in the level one, it's what we learned in physio school. The level two, we
(42:56):
get into the neurology, we get into the vestibular system, we get a
lot into the cerebellum, we get into advanced breath work, we start to
learn how to use kettlebells, we look at cranial nerve testing. So again,
The course is laid out in the exact order in which you would assess somebody. So if you
see a lot of concussion patients or neurological, the level two is
where you're going to start doing all that stuff. But you need the level one to understand the
(43:17):
framework and the foundation for which to build your algorithm on.
And then once you get an algorithm, then you can get creative as
you want. But it's based on fundamentals and principles. which don't
change over time. That's why I set it up this way. It's like,
unless human beings change who we are from
a psychology, neurology, biology, chemistry, and physics perspective, it's
(43:45):
Perfect. And where can people find more information about that and
So amtcertified.ca, we are actually starting
our first cohort September 16th. So everybody who's
enrolled in the level one, level two, they can start it right away. And,
and then we're going to start doing live coaching. We're going to go over case studies, increase
questions for clarity, um, how to apply certain principles so
(44:08):
that everyone can utilize the information. And also it gives us an opportunity
to continue to evolve. and build on
this system. Tommy Swales is
my YouTube, longer format, content there, it's
free. What's my Instagram? Swales.Tom, some
short content, LinkedIn's Tom Swales and Facebook's Tom Swales as well. So
(44:30):
lots of areas in which you can get free stuff, but if you wanna, for
clinicians and coaches who want to really organize and systematize and
Perfect, and for everyone listening, not to worry if
you haven't been taking notes, if you scroll down in
whatever platform you are listening to right now, all of
(44:51):
that information will be in the show notes and one click will take you to
all the social media and to the website. So thank
you so much, this was great. Now, before we end,
I have one question. I probably should have told you this before we started,
but I forgot. So, I have the
last question, it's one I ask everyone, and that's knowing where you are
(45:12):
now in your life and career, what advice would you give to your 20-year-old self?
Trust the process, be patient. One
piece of advice, and I always felt this way, but my father-in-law repeated
it to me. He's like, follow your passion, do what you love, get
(45:33):
really good at it, and money will follow, right? There's
no point. I was never one growing up. If
I wanted to be rich, I wouldn't be a physiotherapist. Let's just put it that way. Like you
don't get into healthcare because I'm like, I'm going to make a ton of money. You
just, you love it. And you like working with people and solving problems and
getting people out of pain and seeing their potential. And now my
(45:55):
career's evolved into teaching other clinicians and coaches how
to elevate their game and do better than me,
right? That's the fun part now is we
do mentorship every week at our clinic. And when
you're going over something the 17th time and all of a sudden it
clicks, you're like, ah, there it is, right? It's just like that level
(46:16):
of excitement, but it's trust the process and be
patient, which a lot of us can get impatient because we want it now,
but time will allow you
to truly understand what we do and why we
Excellent. Excellent advice. Well, Tom, thank you so much. This
was great. Um, and again, everyone, the cohort starts
(46:42):
Perfect. So scroll down, click on that link for more
information. Tom, thank you so much for coming on the podcast. I
My pleasure. And everyone, thanks so much for tuning in. Have a great
Hey everybody, welcome back to the Healthy, Wealthy, and Smart Podcast. I
am your host, Dr. Karen Litzy, owner of Karen Litzy Physical Therapy
in New York City. And today we are
going to be talking about one of my favorite
topics, movement and healing, mind-body connection,
how to engage your clients. And I'm so
(00:24):
happy to have on the show a fellow physical therapist or physiotherapist. um,
for those who are outside of the United States. So
Tom swales is a respected physiotherapist and strength coach
with over 20 years of experience in injury prevention, rehabilitation,
and performance optimization. He created the advanced movement
(00:45):
therapist certification to help professionals enhance client
outcomes by focusing on peak performance as
the founder of comp 50 physio and
performance wellness. Tom has worked with professional athletes, consults
for Olympic and international sports organization, making
him a perfect expert for today's podcast.
(01:12):
So obviously I gave some of your highlights there during the
intro, but can you let the listeners know a little bit more about you,
how you got your start in physical therapy and kind
So I think most of us, we grow
up playing sports and we're always just like, I had a great experience with physio
(01:34):
or Cairo and I just had to become one. Me, because
I love my sport so much and when I got hurt, it frustrated me.
So I wanted to figure out how I could fix myself. So my self-indulgent
of learning about the body, human anatomy, how things
fix, how things repair, how they adapt, that
(01:56):
selfish endeavor kind of led into a natural interest in
all things pertaining to anatomy, human physiology, performance,
and optimization. And so it started in
high school. I got a soccer scholarship down
to the US, Graceland University. I'm an AT as
well. So I did the AT bachelors down there, came
(02:18):
back up, worked for a couple of years, got into the physiotherapy program, master's
program, which I barely got in. I applied
twice, didn't get in both times. And the
University of Western calls me. And they're like, hi, this is Donna
from Western. I was like, hi. She's like, so we got into a situation where
(02:38):
our first choices went somewhere else, and our second choices went
somewhere else, and your name is on the top of the rejection list.
Are you still interested in coming this September? And I said, so
Donna, you're telling me that I'm on the top of the shit pile, and you
want me to come to the PT program? She's like, yeah. I was
like, I'll see you in September. And then hung up, so they couldn't change their mind. got
(03:01):
into PT school, which is very difficult here in Canada, because there's only 12 schools. And
like, I, when I looked, you know, it's 335 schools
in the US at this point, there's still only 12 in Canada. And
so I got in, Got a degree, got
a job with the Canadian ski team, Olympic ski team, so having an AT background
(03:22):
as well as a snowboard mountain background, I
got recommended to work with the Olympic ski team. Did that for two
years, met my wife in the process of that. Once
I finished that, found my mentor, which is key if
you are looking to excel in this field, is
find that person that you want to learn
(03:43):
from that jives with you. So we can talk about that later. Learned
how, through his perspective of
a holistic approach to physiotherapy. He's a PT,
I think he was a dentist at one point, and he did acupuncture, traditional
Chinese, like he does everything, his whole office. Not just his
office, his whole clinic was his diplomas and degrees and
(04:05):
certificates all over the walls. I was like, this guy's unreal. And
his perspective on how to heal, he was
one of those people, he could put his hands on somebody and
he could see inside and then he knew exactly where
to go. He healed from what we
call, he healed from his heart. He was very empathetic and
(04:26):
very intuitive. I appreciated that, but
being a newer physio, I was like, I do not know what
you're talking about. And he would use all this language, and I was like, that sounds very
metaphysical, and I don't know what you're talking about, but I'll go
to that later. So I was like the movement guy. I was the mechanical, give
me the knees, give me the hips, give me everything. Almost
(04:46):
failed physio school because of neuro. And I said, once I pass that, I'm never touching that
again. And then later down the road, I started, you know,
once we opened up our own clinic, I started realizing everything's neuro. Yes,
everybody has a nervous system. Everybody has a nervous system and
everything is neuro until proven otherwise. So I started going
down that path to look at orthopedic problems. That
(05:07):
opened up a whole new world for me. And then I
started looking at, well, what composes the human being?
Like, if we were to distill it down, it's essentially psychology,
people come in with belief systems, right? Limiting beliefs that
we have to break. Understanding their nervous system. How is
the body responding to the inputs I'm applying or the words that I'm
(05:28):
saying? biology, chemistry, and physics. And then once I started studying physics,
especially quantum physics, I started to understand what my mentor was talking
about. So, you know, it's kind of tying it
all together. And looking at it through these five kind of
elements of the human being, now it broadened my understanding
of what we do as physical therapists, and then understanding what
(05:49):
we do, why we do it, and how we can do it better. So then, you know, you start building your
courses on top of that foundation, and then, you know, you can
create a system. It's that deeper understanding of how to help every
single individual human being. But to sum
it up, what's fun
about our profession is it's so vast. It's
(06:10):
so vast, it's hard to define what we do because we can do so many
things. So people are just like, well, what do physical and physiotherapists do?
And you're like, well, we do all this. So you're a chiropractor. Well, no, I do manipulation.
But, you know, I do soft tissue work. Oh, so you're a massage therapist? I'm like, no. I
also do acupuncture. Oh, you're an acupuncturist? No. Like, okay. Right? So.
(06:33):
And then when you blend those manual therapies and then you can bring in the movement
side, kettlebells, gymnastics, bodyweight training, Olympic
lifts, then you can really start to build a bigger picture and bridge
that gap between rehab and performance because really the same thing. So
I know this is a little bit of a long-winded answer, but we can kind
of diverge off of a couple of those topics. But I think
(06:54):
what drew me into physio is just this desire
to help myself, for one, but then this
deep interest in everything that has to do with the human body
and optimizing performance. And then when we had children,
it was like, how do I use some of these biohacks now to kind
of teach my clients how to improve recovery, performance, stay
(07:18):
kicking ass into older age? So I
think it's just fun. It's a fun profession because we get
Yeah, I couldn't agree more. And I
think you're right, the great part about our profession is
it is so vast and diverse and there's so many directions one
can go in. But I want to touch
(07:40):
back to something that you'd said during that, and
that's the influence of the neurological system.
Can you talk a little bit more about that neurological influence
on movement and pain and why that's one of the foundations of
your, when you are looking at a patient, a
(08:05):
So if we distill down what the nervous system's primary job
is, it's survival. Survival of the individual, survival of the species. So
now we have, okay, when someone's in a survival state,
what state are they in? Well, they're in a sympathetic state. Okay, so
now they're either in parasympathetic or sympathetic. When they're injured, when
they have pain, when mindset's not right,
(08:26):
they're in a sympathetic fight or flight. There's no healing, there's no change that happens there.
So I need to do things, I need to say things in order
to get them out of that sympathetic fight or flight. Simply by
being present, simply by asking questions, getting them to tell their story,
because oftentimes they don't get that time, they
(08:46):
automatically start to downregulate because they felt
hurt. So now I've created this connection, I've
created trust, and I've created safety in my presence. Now
that I've affected them psychologically, their nervous system
will start to calm down. Now everything I do from a
movement or manual perspective, the nervous system is going to let me in. So
(09:07):
I realized, okay, when I was younger, I was so eager
to be like, as soon as I asked a couple of questions, I know your diagnosis. And
you cut them off and you start, all right, let me go test the knee. Let me go test the
shoulder. But their body guards. And then you do manual therapy.
It didn't change. Well, because I didn't listen
enough. I didn't ask enough questions. I didn't dive into their longer
(09:27):
history of trauma, right? Like, you know, oh, that
new low back issue was from a whiplash 20 years ago. And
you still can't turn your neck. Well, I don't have pain there, but you've created compensations other
places. So, Once
we start to see the nervous system controls everything and
is the pathway of communication in
(09:48):
the body, if I know
that it's kind of a go-no-go system, if I apply an
input, say touch or modality or
stretch, If I apply it in the right spot, the nervous
system calms down, it reorganizes the system, and all
of a sudden range of motion improves. If I don't treat the right area,
(10:09):
no change happens. If I treat the wrong area, the
body guards more. So now you can use the nervous system as
a form of communication to know if you're moving in the right direction. Am
I treating the right spot? Am I treating what's priority? So
another thing that when we look at how we
developed just embryologically, when you look at the germ layers,
(10:32):
when you look at the order, what's at the center, typically
Sorry, just start where it
(10:53):
has like, because it just kind of froze up for a second. So
start back with what, yeah,
So if we look at simply how we were designed from an embryological
perspective, we're just a series of tubes and wires, right?
Everything is moving up and down. And if we kink
(11:15):
the hose or we compress the tube on one end, it will create
disruption or compensations at the other end. And
that makes it a little bit simpler as to, OK, well, yeah, you have this new back
pain, but I'm more interested in the old whiplash. We need to clean that
up first, because that's the thing that is causing all these
compensations in this new pain problem. Now, if I treat that
(11:35):
and all of a sudden I treat the neck and now they can touch their toes. They're
like, oh, oh my God, my back pain's like 80% better.
Well, it's like, because it was the neck that was driving it. But the neck is more important than
your lower back to the brain. Why? Because it's closer to the brain. So there's a priority of
structures, right? You got things that take up the most amount of energy, brain,
eyes, anything centrally, vestibular apparatus that controls everything.
(11:59):
So if there's old concussions, you gotta make sure that they're clear because if
you've got a cerebellum firing up on one side differently than the other, it's gonna cause orthopedic problems
on one side, overuse. So the
nervous system is super fun because when you
treat the right area, things just move
really quickly. Things unlock because the nervous system is like,
(12:21):
oh, thank you. I will let this go now. It feels safe. But
if we don't treat the right area, we're chasing pain, which is what we
can get caught doing. You know, they might have some temporary relief because
we changed how things felt around the joint, but then it comes back, right?
Well, did you clear the neck? Did you look at nerve mobility? Did
you look at the myotomes, right? Maybe there's some nerve stuff there first that's
(12:43):
tightening the muscles. And people
come in, they're like, well, my pec is tight, my hamstrings are tight. Oftentimes
it's nerve issues. Like 90% of
the time, there's some kind of neural restriction. And
if the nerves aren't sliding and gliding, if there's compression or tension
on one end, the nerves tell
(13:05):
the muscles to tighten up. Muscles are dumb. They only
do what the brain tells them to do. This is what I tell my clients. So before
I stretch and release this muscle, we need to find out why is
it turned on? Is it compensating? Is it protecting? Or
is it trying to stabilize something? Because if I don't find out what it's
compensating for, and we go and release or stretch it, it might make
(13:26):
things worse. We might have just taken away some protection, and all of a sudden, now
we've got an exposed hot nerve root. We shouldn't have released the peck in the upper
trap by needling it. Maybe we should have looked at neck stability first or
breathing or the diaphragm or something else. So when
we know how to talk to the person's nervous system and
use movement as our feedback loop to know if we're moving in the right direction, it
(13:49):
makes it a lot easier for us from an orthopedic perspective. So
that's why I love the nervous system because You look at
it first. Look at it first and a lot of the orthopedic problems go away because
what transmits pain? Nerves. Where's pain interpreted? At the brain. So
why not look at those more important structures before kind of all these peripheral, less
(14:09):
relevant structures such as muscles and joints for survival? If
we tear a nerve, we're in trouble. The body will be happy to
tear a muscle before it tears a nerve. That's why
you stretch, all of a sudden it tears your bicep off. Well, the bicep tear
stopped you from taking that median nerve into end range to possibly cause
(14:30):
Right. And I think it's also important as for people
maybe who aren't in the physical therapy world, that when
you're talking about making a difference to the nervous system, this doesn't happen in
one session, necessarily. This is something that it
happens over time. And there are also
those people, even if you speak with them and you create a
(14:52):
good rapport, it may take several sessions for
them to trust you. So if you're a new therapist and
you're like, well, I heard this guy in the podcast and he says, you
know, once they trust you, then everything poof gets better. And
it's like, well, hold on a second. We have to remember that
some of this is obviously dependent. It's on the patient.
(15:14):
And often this takes time, you
know, and sometimes the patient has that
sort of light bulb moment where they are
like, Oh, wait a second. The therapist said this might happen or
yeah, I am feeling what the therapist said may happen. And
so that's where the trust may come in. It might not even be in an interaction
(15:38):
Yeah, and that's part of the initial process of setting expectations.
Hey, you know what? We're going to get this shoulder to move a little bit better
because we're going to do some nerve flossing, or I might manip your T-spine to
get that to open up, to release this. But because you
haven't moved in that position for so long, it might be a little bit more sore for about
24 to 48 hours. because there's new inputs coming in, right?
(15:59):
There's new positions. And the nervous system and the brain might be interpreting this
new range of motion as, ooh, this doesn't feel safe. I'm not used to this. So
let's create a little bit of a panic signal here for
a little bit until things start to normalize or
find its new equilibrium. But that's also why it's so important as
therapists that when we do some kind of manual intervention, when
(16:21):
we do resets, that we apply
a movement or exercise on top of that to maintain it. Because if
we just crack something or needle something or stretch something and they walk away,
software hasn't changed. So they're going to revert back and in 48 hours, it
feels the same or maybe worse. So that's
why it's so important that we blend and we apply the right exercises
(16:46):
And I think you said something really important there, and that's about setting expectations,
which oftentimes we don't
do. I'm still guilty of that. I've been practicing for over
20 years, and sometimes I forget to set that expectation for
the patient. But in your experience
in over the 20 years that you've been a therapist, how
(17:10):
has setting expectations changed your
Well, I get a lot less emails and phone calls the
next day saying, you hurt me. Why am I so sore? Well,
we talked about this, right? And
it happens far less. And if they're
(17:31):
aware that something kind of not adverse, but
an increased level of discomfort wasn't
explained to them, then they're going to think, well, you
made me worse. I don't trust you. So now you've broken trust. And
it was simply because expectations weren't set. We didn't educate
the client on, hey, just so you know, you might
(17:53):
have a little bit of a flare up just because the body's going
to be moving in a different way it's not used to. If I don't say that,
now we've kind of fallen backwards in the trust. And it's
going to take a couple more appointments to build that back up.
So I'd rather not break that and just set the expectations up
front. But this is where the
(18:14):
longer we've been doing this, that communication part early on
is so critical. And spending more time talking
to the patient, if that's what they need and they need to tell
their story, that's fine. We do our assessments. I've
had patients sit there and talk for 40 minutes because on their intake
form, one of the things they didn't like about their last clinician, they
(18:36):
didn't feel heard. So guess what I'm going to do? I'm going to
give them more time, right? Didn't explain this.
Great. I know what you don't like, so now I'm going to do better.
So once they've been heard and I'm giving
them what they need, well now there's greater trust. If
there's greater trust, there's greater safety. Well, if there's greater safety, nervous
(18:58):
system calms down. Great, now that we're in this receptive state,
I can make changes to your physical body. Your biology, chemistry
will follow along with it. But it's all controlled by the nervous
system and the emotional state. Because at the end of the day,
all people care about is how they feel and how you make them feel. And
if they don't feel safe in our presence, they're not
(19:18):
coming back no matter how good you are. You can be the most technically sound
therapist, but if you can't connect with them and they
Yeah, there's no question. And that kind of
leads into, especially
for our more chronic pain patients, that
(19:41):
kind of mindfulness and awareness, self-awareness of
the patient and mindfulness of the patient. So how
do you help with the application maybe of
mindfulness techniques with your patients? And have you
I think it just starts with, during the assessment,
(20:04):
we set a movement baseline. Okay, you notice how that shoulder's 120? Yeah,
okay, great. We make them aware. We point out how
they're moving or how they're not moving. What parts are moving differently? Oh, see
your straight leg raise? It's like 45 on the right, but it's 80 on the left. Okay, we're gonna remember
that. See how your toe touch? you know, you're at mid-shin, we're
going to remember that. So now we've set a baseline for where they are starting.
(20:27):
Once we start doing the interventions, once we start kind of looking at
where their linchpins are and start unwinding and reorganizing the body,
we go back and check. Now their toe touches, you
know, two inches from the ground, or maybe they're touching the ground. Maybe their
shoulder flexion is completely restored, right? Hey, what's
going on there? Oh, wow, that feels better. Yeah. So it's
(20:48):
making them aware of what they're doing and not doing, and then showing them
the changes that are being made. Because at the end of the day, the
only thing they care about are results. And if you can show them
results quickly, even if it's temporary, which sometimes
it is, because if it's been longer standing, it's gonna take
a little bit more time to develop new movement pathways,
(21:09):
but at least show them in that moment that, hey,
look, we've got increase, we've got 50% more
range of motion. Oh, wow, look, you can reach above your head now
without pain, cool. So it's making them aware of
where they are, and then where they end
up becoming after interventions have been made. You're
(21:30):
like, okay, well, range of motion is here now. It might revert back, but
we're going to keep track of this. And you're also going to keep track of,
oh, well, you couldn't reach up into the cupboard, but now you can without pain.
because we want to create meaningful change. They don't care
if they have 170 degrees shoulder flexion from 150. They
don't care. But if they can reach up into a cupboard and grab a teacup without
(21:52):
pain, that means something. If they can bend over, pick up a
shoe without their back hurting, that's a win for them.
So it's giving them kind of baselines And
then, Hey, I want you to pay attention to how much easier
these things that we talked about earlier that are important to you, how much different
(22:13):
Yeah. So it sounds like you're setting up for them individual self-assessments
that they can do on a regular basis to
kind of check in with themselves and see where they are. Because I know
a lot of times as people progress through, they don't
realize the progress that they're
making. And so to create these little
(22:35):
kind of mini self-assessments at home is a really great idea.
Yep. Something as simple like in the AMT system, we
do what's called a global movement scan with everybody. And we do it every
single appointment just to kind of set a baseline because it changes. Flexion, extension,
rotation, side bend. Can you touch your toes? Can you back bend?
(22:57):
Can you rotate? Does it feel different right or left? Can you stand on one
leg? Can you side bend? Can you squat? Right? Very simple. And
you pick off the movement that's kind of the most restricted, see if
you can change that, and then recheck it. And if
they see a massive change, you're like, great, this is your home test. When
you feel that low back tightness or that groin pain again from sitting too
(23:18):
long, you're going to do your global rotation or your global extension
up against the wall. If it's restricted, you
go do your exercises, and then you check your
work to see if it changed. If it did, great. If it didn't, okay,
try these other ones. It's kind of like finding a lock and key system
sometimes. It's trying to figure out how the
(23:39):
nervous system is organizing the structure, and then find
those main linchpins to kind of get the body to
move a little bit differently. And oftentimes, the first couple of exercises you give
them, as long as your assessment is very thorough and you're
treating the right area, very simple. But
a lot of the times, where the importance is on the assessment. I
(24:01):
think clinicians, we get too eager into treating stuff And
we don't spend enough time on the assessment to gather all the data to
treat one area. Especially when somebody's got
chronic pain, you don't want to over-treat. Spend the time on
the assessment. We know, you
know, people in chronic pain, the assessment's pretty exhausting for
(24:23):
a lot of them. They're like, okay, cool. I'm just going to
treat this one spot. And it might be some gentle myofascial, some
visceral stuff, right? Some breath work on top of it. If
it's shoulder issues, you know, supine line, we're going to release the diaphragm. You're
going to do some shoulder, whatever it is. something to
kind of get, keep them calm. And then one thing for them to do at
(24:43):
home, because if they're an individual who doesn't do exercise,
do you think they're going to do the four or five exercises? No,
Three max. Otherwise you give four, they won't
(25:05):
you know, or less that people are like, yeah, I can handle that. I
can probably do that on my own. Right. Um, and again,
you can get a sense of that in your evaluation
for sure. You know, like I've definitely had people who I've
seen the first time and they're like, give me six
exercises. I will do them exactly. How's you, how
(25:30):
You know, but I usually wait for people to like explicitly
say that to me because usually I'm like, oh, I don't know. They won't
do it. But there are certain people out there who will. So
there are like, yes, I have this three exercise max
as a flexible rule. But of course, there are people on
either side of the bell curve that, you know, some maybe
(25:53):
Maybe it's to your point. Maybe it's just being aware of their posture
Let's just breathe in the right spot, right? Yes. Where
are you breathing? Oh, well, you don't have any breath. You're breathing up into here. Do you have any breaths
you take in a day? About 24,000. How about we just breathe every hour, put
one hand on your chest, one hand on your belly and just breathe into your belly. That's it. And then
(26:16):
just do some neck rotations or some eye exercises, right? To
kind of stack some neuro stuff on there. Like that's
oftentimes what some people need. They need to just be heard and then they just
need to do a couple of little breathing exercises and all of a sudden they're like, Oh my God, my shoulder feels a
Right. And, and how do you work on
resilience with your patients? Cause we've all
(26:38):
had people who are a little, have a little more complicated history,
complicated injuries, chronic pain, where their
capacity is really low. Um, and
they feel like they've seen 500 doctors and 40 physical
therapists and they've done all the things, nothing works. So, How
do you help those people build up their resilience
(27:02):
and build their capacity to accept whatever
the treatment may be? Maybe it's soft tissue work. Some
people don't, I don't like to be touched. I don't like to have anybody touch
me. And I have a history of chronic pain. And
Like, no, give me something else to do. I'll
(27:25):
do it. I'm one of those people. Give me six things to do. I'll do it. Do
Right. Yeah. So. If
people are in an exhaustive state, it
comes back to, you know, you can't prescribe, I need you
to do three sets of 10. Like that doesn't work. Especially
when we're trying to, we got to think of movement as a skill. Yeah. No,
(27:47):
it's not an Olympic snatch where you do one to three reps and
you got to make sure it's perfect. No, you're going to lay on the floor and you're going
to do 10 perfect breaths. Or you're going to do five
dead bugs or whatever it is, right? You get them to feel the right
position. You get them to feel where the breathing's going. And
then, you know, if I do have to give them some little bit of dead bugs,
(28:07):
give them a spine supported position to feel that cross cord reflex or whatever it is,
I said, it might be four reps. It might be 20. Until
you cannot feel the right muscles, keep the right position, if
you feel a pinch in your lower back or you hold your breath, practice is
over. I said, it might be four, it might be 40 reps. I
don't know. But you're going to do the reps. Some days
(28:29):
are going to be better than others. Depends on your sleep, depends on your stress, depends on
whatever. Exercise is stress. Why would I add more
stress to your system if you can't manage it? So we always
want to stop. Let's just say, we'll keep two in the tank. right?
Keep a reserve. You want to work to 80%, but
never to a hundred because as soon as you get to a hundred, you exhaust the system,
(28:51):
regardless of the complexity of the exercise. It all depends on
their threshold. So if laying on the ground and
doing six dead bugs causes them to fatigue out, they
do four and then they go do whatever else
they need to do for the rest of that day. And then maybe in another hour, you
do four more. right? It's like trying to progress your
pull-ups. Well, if you can only do five pull-ups, but you want to
(29:14):
get to 20, you go up to the bar, you
know, 10 times a day and you do two. Right?
You build those perfect repetitions. That builds the neurological framework.
That builds the myelin. That builds those patterns. And when you do
it precisely every single time, the nervous system gets more efficient. So
now when you step up to the bar in a month or
(29:35):
so, you can do 20 pull-ups. But you never train for
20. You just got the volume and the perfect practice in over time. It's the same thing
with rehab. This is where when we look at performance
and rehab, it's the same spectrum. It's just different ends. And
that's depending on the individual. But it depends on what the individual needs.
So to build that resiliency, it's just stay away from fatigue, stay
(29:57):
away from pain, make sure you can feel the right muscles doing the right
jobs, you're breathing properly, and
everything feels like it's supposed to, like we did it in the office. If
it feels different than that, you're done. Go do something else.
Yeah, so it sounds like giving people those little
wins throughout the day will help build resilience, help build confidence
(30:20):
versus to your point, like do three sets
of 10 or three sets of 15 or whatever it may be. If
that person is not ready for that and by the
end of the first set, there are forms all over the place, forget
It's dosing them to feel good. The
(30:40):
mindset of a lot of people is just like, I got to go to the gym and I got to punish myself.
They're a sweaty mess on the floor. They can barely walk. I'm
like, you know you have to do other stuff during the day. Well,
I have a goal. I'm like, okay, cool. You can mentally push yourself through
that for a period of time. I would say eight months before
(31:00):
your nervous system finds every reason not to do this. If
you leave the gym feeling terrible every time, subconsciously, your
brain's going to be like, you know what? I got to drive the kids here. I
really need the rest. You're going to make excuses. If you
leave the gym feeling great every single time, you're training your
nervous system to be like, I want that feeling again. I'm going to show up again tomorrow.
(31:22):
But it's the dose. It's just like manual therapy. It's like
anything. You dose it too much, cause a flare up. You dose it
too little, no adaptation. You dose it just right, that's
the Goldilocks zone. That has to do with manual therapy, movement therapy, training,
rehab, whatever it is. You find that Goldilocks zone of feeling good
and your nervous system switches on, you got more energy, that's it. That's
(31:45):
Yeah. I experienced that the other day. I started taking
Pilates classes again and were
on on a reformer. So, the teacher like
okay three springs everyone I was like, because I
know if I use three springs my forms not going to be good.
So I use two and a half she goes, are you doing two and a half for
(32:07):
a reason I was like, yes. because I want to make sure that I
have really good form. And if I do three, maybe
I can do two repetitions, but then I'm done if
I use two or and I'll keep going with bad form.
Right. So it's like I would much rather lower
the intensity and keep the form. And
(32:30):
to your point, I walked out. I was like, I feel pretty good versus, oh,
my back is sore because I had too much weight on
there. And I don't know what I was thinking. Right. So I'm
even me as a therapist doing this for over 20 years
as well. I have to continuously remind myself to
(32:50):
kind of stay in that Goldilocks zone. And then of course,
you know, as a physical therapist, I'm sure you've done this, you've gone to classes and
you look around and you're like, Oh no, that's
why I don't go to, I don't go to classes for that reason. Oh no, no,
that form is terrible. And look what's happening here. You
know? So I'm like, Oh no, no, no, no, no. It's like, you just
(33:10):
want to go around to everyone and be like, you can use less. It's okay.
I stopped going to a public gyms. Oh,
I just, you know, I have a, I have a, I have a gym in
my garage. I got my kettlebells, my Olympic rings I have
outside of my backyard. I have high bars and dip bars and you
(33:33):
don't need much, you know, kettlebells and calisthenics is primarily, I'll get under
the barbell at my office, but like at our facility, we have
a big performance facility side thing. So if I want
to use a hex bar or barbell, I'll go and do that once a week. But,
Yeah, for that reason, I can't do the
local gyms. It's just like put blinders on. I'm like, oh,
(33:54):
I want to help you, but I don't want to be that guy telling everybody. It's
out of like, I don't want you to hurt yourself, but that's not how it's going
to be received. And then your other point to doing
classes, if you're in a class where you're kind of competing against
yourself, but you're doing it next to somebody else, you're not
(34:14):
No, you know something, I have been able to really take
So I've been doing classes for so long that I am just
focused on myself. I don't even, like, sometimes
I'll look and just be like, oh boy, that form is
not good. But I am just, I
(34:36):
really try and focus on just what I'm doing and try and do better
in this class than maybe I did the one before. But,
you know, with age comes wisdom, as they say. So my
wisdom now is like, I am not I don't care what
the person next to me is doing. I don't care where their heart rate is
or how fast they're running or none of it. Yeah, none
(34:57):
of it. As a matter of fact, I was at the gym maybe two months ago and
I was sort of run walking on the treadmill and there was a woman next
to me and she was walking and all of a sudden she started running and she was walking. And
when we were like I was cooling down, she leans over, she goes, thank
you. I was like, for what? She's like, you were running. So then I said, you
(35:18):
But I, yeah, but I was like, oh, you're welcome. Like I didn't, I
knew she was running, but I didn't realize like the effect that,
you know, the person next to you has. So, you
know, but yeah, I've, I've tried to kind of block that out.
Well, energy feeds energy, right? Somebody
(35:40):
who's got higher energy in the room, you want to match that because it's
exciting. You can feed off that. You're in a high-energy room, you
get elevated. You go into a low-energy room, it sucks it out of you. That's
why being around people is so awesome, but
it can also be so detrimental. But we also have
to realize all we should be doing better is
(36:01):
than our former self. So I want to do one more rep better
than yesterday. I want to do one more pound better than
last. It's a journey. If we're looking for an end
goal, well, what's the end goal of human beings? Death. So
let's not race to the grave, but if we're
constantly hurting ourselves, and we can't train, we're
(36:23):
supposed to train for, at this point, longevity, unless we're doing some
kind of high performance thing. Which again, high performance, different
from longevity, it's pushing the limits, it's always on the threshold of injury, it's always
on the threshold of illness, different
than from longevity. So, what's the
rush? What are we chasing after? Unless you have some specific goal,
(36:45):
at the end of the day, make it feel good. Make it so that you want
Yeah, and I think that's great advice, again, setting those
expectations for our patients or our clients, because
it doesn't matter how old, I mean, I have patients who are in their
80s who are going to classes. So it doesn't matter how
old the patient is, but it is really important to set
(37:08):
those expectations and get them into the
Yeah, because you want to show up, the goal is to show up at class the next
That's right. Yeah, that's right. Okay. I
could talk about this all day, but let's talk a little
bit about the advanced movement therapist certification. Can
(37:31):
you let, like, what is it? What does it entail? Go ahead.
It's a framework built on those fundamental principles that I mentioned earlier.
Yeah. So psychology, neurology, biology, chemistry, and physics. And
I talk about those in a presentation I do. I don't talk about
it too much in the course because I want it to be very tactical and
(37:53):
applicable. And the five elements are
more kind of the philosophy behind it, right? We talked about
creating connection with neurology, movement. Biology,
how the cells are adapting to tissues, all that stuff. And then the framework
is, you know, how did we learn to move when we came into this
world? It's from the ground up. How are we
(38:15):
organized and structured from the top down? Once we
started to learn how to move and control our
center, well, we learned and we start to build movement from
spine supported, suspended and stacked, right? And then
we start to load it, then we start to create propulsion. So
once we start to realize the organization or the order in which we learned how
(38:36):
to move, we can often just go back down to one of those earlier stages
and clean up some movement patterns. And all of a sudden this more advanced pattern
over here is a little bit easier. The idea behind
it is to really simplify going
through an algorithm. Like every time we assess, We
have a set process, and we go through it. As a veteran
(38:59):
clinician, we should, at this point, have our checklist. Oh,
hit this crossroad. Let's diverge and let's check this
over here. Okay, that's clear. Let's go back onto the main highway. But
when we come out of physio school, they don't teach us that. They throw all
the information at us, at least here in Canada and from what
I've talked to in the US with some physical therapists. So
(39:21):
we learn how to assess the shoulder, all the parts, the pieces, diagnosis, all
that stuff. We learn how to treat the shoulder, right? And then we move
on to the hip, and then we move on to the spine. Like, they teach all the parts,
but they don't teach us how to assess the body as a system first, to see
where some of the restrictions are, to assess kind
of an order of priority, nervous system, for example. Maybe
(39:42):
you look at neural tissues before you look at muscles and joints. Um,
and then once, once you start to see, well, your rotation isn't really good to
the left, let's look at your T spine. Let's look at your hips. Let's look at all the joints that
rotate that may be kind of blocking that rotation. All right, great.
Now that we see that you can't actively and passively do this, let's
do our muscle testing. Let's do some myotoma. Let's do some, uh, muscle
(40:03):
testing, resisted range of motion. Let's look at all the parts and the pieces, right?
Once you start looking at the system and then pieces, then you start to see, Oh,
these pieces over here. Gotta love them, aren't
moving. So now we're like, well, if we can't rotate through the
T-spine, you might be rotating a little bit too much into your lower back, causing
some compression on that side, which is then causing the neural compression and
(40:26):
some of that straight leg raise or that sciatic nerve problem. Well, let's
just restore the T-spine rotation with some breath work, some rib mobs.
Maybe it needs a manipulation, do some rib lifts, whatever. Now, all of
a sudden, low back pain goes away. Well, it's because we redistributed forces
across the body. And then once we've kind of reintegrated
the parts, now we put it back into the system. So
(40:48):
it really simplifies the process, but it's a
roadmap as to, okay, great, we have an ACL, we
have a hip impingement, we have this. It doesn't matter what the injury is, go
through your checklist, go through all the parts and the pieces, go
through the order of the system. It will show you exactly where the
restrictions are. and it makes it so much easier. So I
(41:08):
created this one for the new grad to increase effectiveness quickly,
to utilize the information that we have out of school,
organize it into a very useful format. The
veteran clinician, which I became frustrated because these
are all me, You take 100 plus courses. It
(41:29):
becomes flavor of the month. You're like, all right, needling. Everyone gets needling this month.
Oh, that doesn't work. Everyone gets myofascial release. Oh, everyone gets manipulation. It
became that. And then you're like, I don't know what works for anything. So
you have all these tools. What it does is it organizes your
tools. right? It tells you, it gets, you get to this roadblock and
you're like, Oh, I got to go after a joint restriction for the hip. Great. Let's do some
(41:50):
needling. Let's do some mobilization with movements. Let's do some hip
90 nineties. So you start to learn how to deploy the
right tools at the right time for the right person, for the right purpose. And
then as the clinic owner, You can't see all
the people, and the point of running a clinic is, well,
you hire staff to help more people. Well,
(42:13):
you can't replicate yourself, but the easiest way to do that is create a system and
take what's in your brain, take that algorithm and structure, and
teach those around you. So now you can systematize and operationalize results
across clinicians. New grad, veteran clinician, doesn't
matter. Everybody's effective. Everyone's speaking the same language. Now,
I'm not saying that everybody thinks in the same way. I want them to go
(42:34):
out and do different courses, get different tools, get different lenses, but
plug it into the framework. The difference between the AMT
and a lot of other courses, this is a framework to build knowledge
and organize what you have, so you can be more effective with
what you have, regardless of how much you have. Because everything
in the level one, it's what we learned in physio school. The level two, we
(42:56):
get into the neurology, we get into the vestibular system, we get a
lot into the cerebellum, we get into advanced breath work, we start to
learn how to use kettlebells, we look at cranial nerve testing. So again,
The course is laid out in the exact order in which you would assess somebody. So if you
see a lot of concussion patients or neurological, the level two is
where you're going to start doing all that stuff. But you need the level one to understand the
(43:17):
framework and the foundation for which to build your algorithm on.
And then once you get an algorithm, then you can get creative as
you want. But it's based on fundamentals and principles. which don't
change over time. That's why I set it up this way. It's like,
unless human beings change who we are from
a psychology, neurology, biology, chemistry, and physics perspective, it's
(43:45):
Perfect. And where can people find more information about that and
So amtcertified.ca, we are actually starting
our first cohort September 16th. So everybody who's
enrolled in the level one, level two, they can start it right away. And,
and then we're going to start doing live coaching. We're going to go over case studies, increase
questions for clarity, um, how to apply certain principles so
(44:08):
that everyone can utilize the information. And also it gives us an opportunity
to continue to evolve. and build on
this system. Tommy Swales is
my YouTube, longer format, content there, it's
free. What's my Instagram? Swales.Tom, some
short content, LinkedIn's Tom Swales and Facebook's Tom Swales as well. So
(44:30):
lots of areas in which you can get free stuff, but if you wanna, for
clinicians and coaches who want to really organize and systematize and
Perfect, and for everyone listening, not to worry if
you haven't been taking notes, if you scroll down in
whatever platform you are listening to right now, all of
(44:51):
that information will be in the show notes and one click will take you to
all the social media and to the website. So thank
you so much, this was great. Now, before we end,
I have one question. I probably should have told you this before we started,
but I forgot. So, I have the
last question, it's one I ask everyone, and that's knowing where you are
(45:12):
now in your life and career, what advice would you give to your 20-year-old self?
Trust the process, be patient. One
piece of advice, and I always felt this way, but my father-in-law repeated
it to me. He's like, follow your passion, do what you love, get
(45:33):
really good at it, and money will follow, right? There's
no point. I was never one growing up. If
I wanted to be rich, I wouldn't be a physiotherapist. Let's just put it that way. Like you
don't get into healthcare because I'm like, I'm going to make a ton of money. You
just, you love it. And you like working with people and solving problems and
getting people out of pain and seeing their potential. And now my
(45:55):
career's evolved into teaching other clinicians and coaches how
to elevate their game and do better than me,
right? That's the fun part now is we
do mentorship every week at our clinic. And when
you're going over something the 17th time and all of a sudden it
clicks, you're like, ah, there it is, right? It's just like that level
(46:16):
of excitement, but it's trust the process and be
patient, which a lot of us can get impatient because we want it now,
but time will allow you
to truly understand what we do and why we
Excellent. Excellent advice. Well, Tom, thank you so much. This
was great. Um, and again, everyone, the cohort starts
(46:42):
Perfect. So scroll down, click on that link for more
information. Tom, thank you so much for coming on the podcast. I
My pleasure. And everyone, thanks so much for tuning in. Have a great
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