July 7, 2025 • 49 mins
In this episode of the Braun Performance & Rehab Podcast, Dan is joined by Alexa Degan to discuss her recovery from 2 ACL injuries. Steph Allen is the founder of ACLResolve. After going through an unsuccessful ACL rehab herself, and realizing over the next decade that she was one of MANY that had had that experience, she created ACLResolve. Here, Steph and her team ensure that ACLers get the support and expert guidance they deserve so that they can get back to sport stronger than they were before. Steph is also the co-founder and lead mentor for Clinical Athlete. For more on Steph be sure to check out aclresolve.com @stephallen.dpt @aclresolve and @clinicalathlete *SEASON 6 of the Braun Performance & Rehab Podcast is brought to you by Isophit. For more on Isophit, please check out isophit.com and @isophit -BE SURE to use coupon code BraunPR25% to save 25% on your Isophit order!**Season 6 of the Braun Performance & Rehab Podcast is also brought to you by Firefly Recovery, the official recovery provider for Braun Performance & Rehab. For more on Firefly, please check out https://www.recoveryfirefly.com/ or email jake@recoveryfirefly.com***This episode is also powered by Dr. Ray Gorman, founder of Engage Movement. Learn how to boost your income without relying on sessions. Get a free training on the blended practice model by following @raygormandpt on Instagram. DM my name “Dan” to @raygormandpt on Instagram and receive your free breakdown on the model.Episode Affiliates:MoboBoard: BRAWNBODY10 saves 10% at checkout!AliRx: DBraunRx = 20% off at checkout! https://alirx.health/MedBridge: https://www.medbridgeeducation.com/brawn-body-training or Coupon Code "BRAWN" for 40% off your annual subscription!CTM Band: https://ctm.band/collections/ctm-band coupon code "BRAWN10" = 10% off!Ice shaker affiliate link: https://www.iceshaker.com?sca_ref=1520881.zOJLysQzKeMake sure you SHARE this episode with a friend who could benefit from the information we shared!Check out everything Dan is up to by clicking here: https://linktr.ee/braun_prLiked this episode? Leave a 5-star review on your favorite podcast platform
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
Welcome back to another episode of the Brown Performance and
Rehab Podcast, powered by Isofit and Firefly Recovery. Isofit is
my go to for all things isometric strength training. For
more on Isofit, be sure to check out isofit dot com.
Episodes like this are made possible by Firefly, the official
recovery provider of the Brown Performance and Rehab Podcast. For
(00:22):
more on Firefly, be sure to check out Recovery firefly
dot com. This episode is powered by doctor Ray Gorman,
founder of Engage Movement. Learn how to boost your income
without relying on sessions. Get a free training on the
Blended practice model by following at Ray Gorman DPT on Instagram.
Joining me today on the podcast is Steph Allen. I
(00:44):
had the pleasure of meeting Steph back in February at APTA,
and I really appreciate all the amazing work she's doing
in the space that way, especially around the ACL and
just elevating the state of rehab in general, and we
discuss all of that and more in this episode today.
This is an amazing conversation with Steph. Really appreciate her
(01:06):
time and highly recommend you check out her page and
all of the amazing stuff she's doing in the space.
If you haven't already enjoy Steph, welcome to the podcast.
I'm super excited to work with you today. In a
huge shout out to our mutual friend Katrina for helping
us get connected for people who aren't familiar with you
and all the incredible work that you've been doing in
the clinical space, in particular surrounding the complex knee and jury.
(01:28):
Would you mind filling people in a little bit about
who you are and all the great work that you've
been doing.
Speaker 2 (01:33):
Yeah, I appreciate that, and one hundred percent shout out
to Katrina, Missy Katrina. Yeah, I'm excited to be here.
I crazy to think about it, but I've been a
PT for eleven going on twelve years now. It's like
kind of wild to think about. I feel like, I know,
like just finished residency and was like doing travel PT and.
Speaker 3 (01:57):
Like not really knowing what I was doing.
Speaker 2 (01:59):
For all you people out there, don't worry. We know
enough of what we're doing when we're new grads that
you're fine. But yeah, so, I mean, there's it's a
much longer story, but essentially I was in, I did
a residency, then did travel PT for a couple of years.
Then I was in Boston for almost seven years, had
a really cool private owned sports Ortho clinic and really
that is where I kind of like dove deep honed
(02:22):
my skills, got a lot of practice with mostly ACL
but really all knee injuries, and was lucky that our
set up at that clinic although you know, moderate volume,
not like a super crazy high volume, but you know,
probably middle of the road. But in general how we
were able to treat was supported in terms of being
(02:45):
able to deliver you know, high value care, and so
that is I got a lot of practice, a lot
of reps at that clinic in Boston, and then you know,
life and career is funny. There was just some some
things that I need to needed to change, and namely,
you know, when most of your caseload is an ACL
(03:06):
injury or some other you know, complex or longer term
rehab situation of the knee, I was feeling a little
bit like my hands were tied in terms of I
was programming for all these people outside of their sessions,
knowing that you know, the most they were seeing me
was twice a week. They were needing to do so
much more right and we'll probably get into some of
(03:28):
that in terms of, you know, how the rehab process
for really highly active people probably needs to look a
little different after these injuries. So it was just a
real quick uh I would call it burnout, but really
just kind of like you know, programming for people outside
of sessions, also doing progress notes and regular notes, and
it just I couldn't bring all of me to the
(03:51):
table most days, and I didn't like that, so I
ended up going down to part time and then you know,
wouldn't have guessed it, but ended up starting my own
thing virtually. That is, that's been almost four years now,
and with some prospects, we're moving back generally to the
Boston area in the next year and hoping to try
(04:12):
to do something hybrid. So that's on the horizon, meaning
like a mix of virtual and in person. I don't
know exactly what that looks like yet, but yeah, that's
where I'm That's where I'm at currently and just you know,
continuing to try to learn.
Speaker 1 (04:27):
Yeah, congratulations on the future return to Boston, and what
an incredible journey and just a wealth and knowledge and
experience you have from your years as a clinician that
way and It's interesting because you kind of hit it
hinted at this issue that we see in the clinical
practice space, especially with athletes that are facing some of
these complex knee injuries like ACL or ACL and meniscus
(04:50):
injury that take nine to twelve sometimes even longer from
a month's standpoint, to get back to where they want
to be where you know, maybe they don't need to
see their PT on a regular basis anymore, right, But
there's multiple sides to this story. There's the patient who
is frustrated by the fact that they're only able to
see their PT once or twice a week, or maybe
(05:12):
they've got a whole lot of hitting costs that they
have to deal with from an insurance standpoint. I just
spent an hour this morning actually dealing with that with
someone where she got hit with some surprise bills from
almost two years ago, which is just insanity to think about,
but it happens more often than I think we realize.
So we've got this issue for the patient not getting
(05:33):
access to the care that they need and getting hit
with some surprise bills. And oh, by the way, even
if they are authorized to get care and they're seeing
care from a PT three times a week. There's then
the question of is the PT experienced in working with
this kind of injury, because unfortunately, our outcomes, regardless of
(05:53):
what level of athlete you are professional all the way
down to middle school, high school, are not as good
as they should be. In my opinion, I have no
issue throwing our profession under the bus for this. But
you know, we look at that one in three injured
ACL patients that don't return to sport, and I just
can't help but wonder if that number should be a
little bit lower, if that number should be a little
(06:15):
bit better, because maybe, you know, clinicians, maybe we need
to look ourselves in the mirror sometimes and say what
could we be doing different or what could we be
doing better. But in defense of the clinician, as you mentioned,
sometimes you've got a lot of patients to work where
you have a lot of things going on, and it
could be very very difficult to try and you know,
pour from a cup that's full, if you will, when
(06:38):
you're constantly emptying your cup over and over and over again,
balancing the demands of clinical practice and all these other
life demands that I feel like are not discussed enough
that way. So we kind of find ourselves in this
weird problem area for the patient who's faced a complex
knee injury, where there's a lot that they need, but
unfortunately it seems like the current system that we have
(07:01):
in place doesn't necessarily provide the best for them or
provide what's necessary to get them all the way back
to return to sport the majority of the time. And
maybe I'm crazy for making those claims, but I just
feel like that's kind of the current state of you know,
our healthcare system and providing for the athlete following a
complex knee injury that.
Speaker 2 (07:22):
Way, yeah, I think, And it's it's not only a
complex knee injury. There's definitely other I think potentially more
chronic injuries as well. And then it's it's interesting they
almost kind of I think, not to categorize an ACL
injury or a complex knee injury as chronic. But technically,
(07:45):
if you're going by the definition of chronic, the amount
of time that it takes to you know, by definition
fully recover, that's a chronic issue. It's like it's there
are multiple phases. It's almost like, in my mind, a
chronic issue that you just know going in is going
to be chronic, unlike you know, an ankle sprain or
(08:07):
something where you've had some naggy shoulder pain that you
go in for and you're not really sure how long
it'll take to sort of improve. You know, some people
things end up being more chronic, others not. Like this
is a situation where you know, to your point, like
you can pretty much guarantee that it's going to be
at least nine to twelve months, especially based on research
right now, and that is without any setbacks, without any
(08:30):
like hiccups or anything, and often with a plan and
a provider that you know is experienced, because it just
does seem to take that long. And you know, that's
even aside from different graphs, because different graphs tend to
take a little bit longer. It's probably a whole different conversation.
But yes, to your point, I think that unfortunately it's twofold,
(08:54):
at least in my experience the system itself. Again, I
was lucky to be in a place that really allowed
me to treat how I believed, but it was still
every thirty minute sessions and a lot of times I
was just needing to see two to three kids at
a time after school, which is like okay, was you
(09:17):
know in some ways good, like they could do some
things together depending on what stage they were at and whatnot.
But that combined with the amount of space and equipment
we had, you know that there was definitely some limitations there.
And then again I knew that they needed to be doing.
Most of these at that time were high school kids, right,
so they're going back to a sport where or we
(09:39):
are working to try to prepare them to be doing
something sport related, very active, probably six days a week.
And if they spend a year doing things twice a
week and maybe one other day, if I try to
hold them accountable for one other day on their own,
there's a big gap there, right, So I was running
into that program for people outside their sessions, like I
(10:02):
was saying, And so that's that's in the case of
a provider that is sort of specialized in that area
and knows what they need. In a lot of cases,
especially at higher volume places, they're seeing fifteen twenty people
a day, maybe like that's not an exaggeration. So there's
no way that that pta as a human has the bandwidth,
(10:24):
nor should they if they want to take care of themselves.
And actually, like eat dinner and sleep between shifts that
they're going to like write programs and be able to
kind of like correspond the email with people between sessions.
So definitely system is one thing. I think the other
issue is, you know, we are we're generalists. When we
(10:47):
leave school, I can't recall diving deeper than the anatomy
and healing timeframes of acial injuries in actual like didactic
work in school. There's just not not really time for
it because we need to learn all the things, which
I totally understand. But similarly to how I would not
(11:09):
feel comfortable with somebody after a finger tendon surgery, you know,
you tend to if you have an interest in an area,
sort of like niche down, really dive deep understand everything
about it that you can. And that's just not necessarily
the norm with anybody at a general sports ortho clinic.
(11:29):
And so I think that people are going to the
place that their insurance covers and where their surgeon sends them,
but it isn't always necessarily going to be the best
fit for them, and people don't realize that they have
call it health literacy or whatever, just doctor patient dynamics.
(11:50):
You know, they don't necessarily have the knowledge and maybe
confidence to basically shop around for a provider.
Speaker 1 (11:58):
Yeah, And it's interesting you say that about shopping around
for a provider, because I've noticed patients more and more
are doing that with surgeons. They're getting second opinions, sometimes
even third opinions. And I would love to see something
similar from a PT standpoint or a rehab standpoint. I
would love to see an evolution in the system where
it's almost like the patient gets like a like almost
(12:20):
like a Q and a kind of session with the
PT almost like, Hey, what's your experience working with patients
that have had similar injury to mine or the same
injury as mine? What kind of outcomes have you seen
from the surgeon that I've picked that way, do you two.
Speaker 3 (12:34):
Work closely together?
Speaker 1 (12:35):
Like there's so many different factors to consider there, But
ultimately it becomes a question of how do we reach
the people who possibly don't even know they need to
be reached, and you know, are just kind of following
the advice that's given to them and doing what they're
told and then you know, unfortunately finding themselves in a
very difficult situation later down the line that way, And
(12:57):
I think ultimately the more we raise the floor for
everyone and kind of raise that bottom line standard of
what we're looking for, the better it's going to be
for everyone involved that way. And you know, I know
you talk about this all the time, and I see
you post about it all the time as well. There's
a lot of common trends that I think we see
missing in athletes and patients who have underwent knee injuries
(13:19):
or even injuries in other areas. Like you mentioned, that
just seem to be common theme themes that come up
over and over and over again, and it's like, hey,
if nothing else, maybe we could start here, Maybe we
could start with the big rocks in this jar of
life instead of arguing over a little small details like
the sand in the jar, Let's you know, tackle some
big rocks if nothing else. And you know, at least
(13:40):
from one of the things that I've seen from a
lot of athletes who struggle mid to late stage ACL
in particular, a lot of them do not own knee extension,
whether that's you know, not getting full extension range of
motion back or not getting good knee extension strength back.
Regardless of what it is, there's some kind of issue
you that ensues with the extension, and I know you
(14:02):
mentioned different graph types, and that seems to be regardless
graph type quad, bTB whatever, the quad is very difficult
to bring back. So, you know, if nothing else, I
think that it'd be awesome to see our standard and
framework kind of evolve in a way that says, hey,
look at the minimum, we need to make sure that
we're getting people back to a point where they have
(14:22):
full range emotion equal between the left and the right,
and they need to have really really really good strength
and not just you know, oh well, it feels strong
to my hand, like, I would love it if we
could find a way to evolve that into something a
little bit more objective, if you will, not to say
it's not objective, but I would say it's just a
little bit inconsistent between what you might say is strong
(14:44):
versus what I might say is strong. And I think
the more that we kind of have the conversation around
that baseline framework and elevating the floor for everyone, the
better we're going to see our outcomes get across the board.
Speaker 2 (14:57):
Yeah, I do think that, you know, you mentioned a
couple of questions that people can ask in terms of
when they're kind of shopping around. I think the analogy
or the comparison of you know, we don't think twice
about getting a second opinion with a surgeon, like what's different?
In fact, I would, you know, argue it would be
more important to get a couple of opinions with the
(15:20):
PT because they're going to be spending all the time
with you. So yes, I definitely agree with that. I
think that the one of the other things could double
as a question that you ask as well. But in
terms of raising that floor and kind of having you know,
I think of certain things being sort of bare minimum
in terms of bareminium necessities. Essentially, for if you are
(15:43):
going to consistently, if you are a clinic that is
going to consistently see post top patients, particularly knee injuries,
that are going to be returning back to any form
of active lifestyle, you need a way to objectively test
their strength. And that doesn't mean that you need to
go out and buy a huge isokinetic machine that's like
(16:03):
fifty grand. You can buy a tin deck force gage
that's two hundred dollars. It was two hundred dollars like
a couple of years ago. But either way, like something
very in terms of like a clinic expense very affordable
business right off, and you know, having either a clinician
that works there that knows, or have somebody come in
(16:23):
to do some sort of brief traits, very user friendly
type of thing. Most clinics have something sturdy enough to
set it up on. You know that to me is
like to your point, it's you. You literally I feel
strongly enough about it to say that it's like, well,
borderline mail practice to be progressing somebody through ACL rehab
(16:48):
without knowing what their quad and hamstring torque to bodyweight
ratio and LSI limb symmetry are. Like, it's just it's
so accessible now, it's like almost not excusable, if that makes.
Speaker 3 (16:58):
Sense, makes a lot of sense.
Speaker 1 (17:01):
And I mean I completely agree with your point, right Like,
you know, before you progress someone to the next stage,
it would make sense to have.
Speaker 3 (17:08):
Them earn that right to progress.
Speaker 1 (17:11):
And I almost think about it this is probably a
terrible analogy, but I think about it very similar to
how we look at like the school system, right, Like
you don't just jump into PT school and go right
into you know, the most advanced courses, the eight hundred
level courses. Day one, you earn the right to get there.
You take your general biology and your general physics, and
(17:33):
if you're like me, you curse out every single day
of it because what do I need to know about
that stuff to be a pt. But ultimately you put
your time in and you put the work in. There's
a lot of checkpoints along the way to make sure
that you've made the progress that you need in order
to earn that right to progress. Now, obviously everyone's going
to debate on what that correct assessment is and if
(17:55):
it's actually telling you what you need to know, but
we could have that conversation a separate time. In general,
I think there's something to be said about having that
phased progress or that phased process that has checkpoints along
the way where you stop, you pause, you test some stuff,
and you say, are we where we want to be?
Are we where we need to be? Are we good
(18:15):
to progress to the next level? Or do we maybe
need to stay here a little bit longer and earn
that right to progress later on?
Speaker 3 (18:22):
Yeah?
Speaker 2 (18:23):
That's I mean, you know, we refer to it as
like criteria based progressions versus timeline. Unfortunately, there's still a
pretty pervasive sort of societal and also in the medical field,
like expectation that like I'm going to run out twelve
weeks and I'm going to start sports stuff at six months,
(18:44):
and some people can do that. I can tell you
from working pretty solely with almost all ACL knee injuries
for the last I don't know, at least six years,
probably more than that. It's rare and the just I
(19:04):
think if people had the expectation of kind of more
what you were alluding to in terms of, Okay, I'm
gonna work my butt off in each stage at a
certain timeframe. We're gonna test some things to see exactly
where I am. The numbers don't lie, right, So like
if if the numbers are, you know, not necessarily where
(19:24):
we need them to be, then it doesn't necessarily mean
that we can't progress in some other ways. But in
certain areas let's say it's strength, let's say it's range
of motion or whatever, we got to kind of stay
at this level a little bit kind of work, you know,
side to side or laterally versus increasing anything, and then
you basically kind of like then earn the right or
(19:47):
the milestone or checkpoint to continue. And that in and
of itself, though it sounds super annoying. I try to
explain to people, like I'm a big expectation setting person
because I think of people go into this injury, let's say,
either whether they had the injury themselves or somebody else
that they know has had it, or they know nothing
(20:10):
about it, but then they do a huge Google dive
right when they get injured, as I probably would too
if I didn't know, and then they go in again.
Now with some biases everyone does, or some expectations, and
a lot of times those expectations are not going to
be conducive to them having a real good time mentally
(20:31):
because they're not realistic. So unfortunately that does oftentimes fall
on us to like reset those expectations, make sure everybody's
on the same page. But you know, that whole process
of testing, seeing where we're at modified, you know, the
testing is just as much for us as well. We
need to tweak the programming based on that and make
(20:53):
sure like, okay, you know, when we get into some
later stage, maybe like rate of force development is really
you know, not coming along for whatever reason, let's revisit
that and see where we can maybe make a greater
focus of that in the programming. So you know, like
being able to see the testing is like, this is
(21:14):
literally just information that just tells us where to go.
It doesn't mean I'm failing, It doesn't mean I'm and it.
You know, it does kind of dictate your pace a
little bit, as it should I think if it was
seen a little bit more in that light versus you know,
a test you have to pass and it tells you
what kind of person or athlete you are. And a
(21:35):
lot of times, sometimes or a lot of times, people
are tested and then the clinician or even surgeon will
kind of give a little like wiggle room and still
allow them to continue to do stuff. If you let
that happen once, then the testing later on it just
just doesn't hold the same clout for the person. And
then a lot of times people are ended up, they
(21:55):
end up being cleared probably sooner because they're like close enough.
And that is a whole other reason. In turn, Like
there's many reasons why I think the re injury rate
is really high, but that's another one that I don't
think people talk about a lot.
Speaker 3 (22:09):
No, one hundred percent.
Speaker 1 (22:11):
And you bring up such an interesting point too, in
the sense that the testing can be just as much
for the clinician as it is the athlete as you mentioned.
And I think that's something else that is not discussed
enough is no one gets it right one hundred percent
of the time. No one has every answer for every
person every time. Everyone's a little bit unique and a
(22:31):
little bit different.
Speaker 3 (22:32):
And how I might you know.
Speaker 1 (22:33):
Go about loading One person's squad might be different than
the next one, for example, So we can't just use
the same things and expect it to work for every
single person that walks through our doors. That way, we
have to add that individualization element to it, and sometimes
we have to adjust as we go and realize that, hey,
you know, maybe this exercise isn't producing the response I
(22:56):
want to and kind of course correct ourselves. But to
your point, the more you test regularly, the more you're
going to kind of be able to kind of assess
those things in the moment. Right If you don't do
any kind of testing on knee extension, for example, until
nine months out, then you know, you could have potentially
prevented a huge strength deficit if you tested maybe four
to six months out and bought it a little bit
(23:18):
earlier instead of getting that far out and testing for
the first time and I think it makes the decision
process a little bit more easier when it does come
time to talk about return to sport or return to play,
right like, instead of it being just one snapshot in time,
maybe instead we kind of build it out as a continuum,
a progression, and we're able to get data points that show, hey,
(23:39):
this is where we were, this is where we need
to be, and now we've met that, you know, end
goal of where we need to be, and here's how
we got there.
Speaker 3 (23:46):
Right.
Speaker 1 (23:46):
You're almost able to map it out and look at
the person that you're working with almost like their own
case study, and kind of create this like an equals
one research on their own case that way, And I
think it's really really powerful and impactful to do that
kind of stuff. But you know, as we mentioned, there's
a lot of issues in the space, but there's also
(24:06):
a lot of people such as yourself and your team
that way, they're doing phenomenal work and solving a lot
of these issues and having really great outcomes working with
people oftentimes not even getting to put hands on them
and getting really good outcomes as well, which I think
blows a lot of clinicians' minds because they feel like
they need to see it in person or they need
(24:27):
to put their hands on someone in order to tell
that you know, they're getting progress. But if you're able
to do it without seeing that person in person a
lot of the time, I'd be interested to hear more
about that. You know, how did you go about transitioning
from that in person to virtual based care, if you will,
And how have you been able to you know, meet
all these different criterion and you know, develop a framework
(24:51):
that is effective for you and your team that way
when you're oftentimes not even seeing a person in person.
Speaker 2 (24:57):
Yeah, I mean to be honest, I was without like
sort of unknowingly already doing it a little bit when
I was in the clinic, I was programming for people
with like Excel sheets and checking like you know, aside
the only thing that really wasn't happening that happens now
with like through ACL resolve, like through the business is
(25:21):
like video feedback. That was pretty much the only thing
that wasn't happening. And obviously we have a lot more
systems and accountability built in now, you know over the
last four years that the systems put in place really
do help a lot with that. But I think for me,
it was like other than kind of like the first
(25:42):
post at visit and maybe the first couple of weeks
and sometimes not even every session was I actually doing
anything with my hands. One of the reasons being, especially
if we're just taking acl for instance, you have the
injury itself, which is trauma to the joint, then lots
(26:03):
of swelling however long that you're doing ideally prehab, but
you know, between injury and surgery there's lots of swelling.
You're trying to get range of motion back, You're trying
to get the quad working, like going into surgery in
the best shape that you can. Then the surgery is
another insult to the joint again another inflammatory process, rightfully so,
because it needs to go in and heal everything. Potentially.
(26:26):
It used to be also that they would use ephemeral
nerve block in term for pain control. They're largely getting
away from that and using either aductor or some other
more local, less intense anesthetics so that you weren't also
getting the femoral nerve anesthetized that innervates all of your quads,
(26:47):
so that essentially was a third insult to the knee
and the quads. And then after surgery, you're trying to
you know, depending on the situation. Sometimes people were trying
to like crank into extension and flow. Like a lot
of people looked at nay Mars rehab on Instagram, which
was like comical because it was pretty much the quintessential
(27:10):
everything that you should not do, and so all of
that to say, like I'll land the plane here, but
like that knee is so hot oftentimes and inflamed at
the beginning. If I'm trying to manipulate it past really
what it's kind of willing to cooperate during a one
(27:30):
hour session. Maybe like they may be there with me
for one hour, but I'm really only one on one
for thirty minutes. We can better use our time. So essentially,
what I found myself doing a ton of was like
educating of like Okay, i will show you how to
do pateller mobes, I'll show you how to set up
a heel pop prop. Because what's going to need to
happen is this is going to need to be a
(27:51):
low and slow thing. You need to gently nudge that
knee and show it that extension is okay. You need
to nudge into flection. You should not be cranking on
it because what your body will do. It already thinks
that this knee is there's a catastrophe here, and it
doesn't want to The nervous system is just saying, like
I don't want to load this thing. I don't want
to move it. We need to protect, we need to
(28:12):
basically seize up. It's something Eric Meta talks a lot about.
He's one of my biggest mentors, and like your job
is to basically like give it lots of inputs during
the day, like, hey, we're going to like settle into
extension here, We're gonna you know, because it's going to
backfire on you. So essentially that coupled with the fact
that like, okay, when I realized in practice what I
(28:34):
was doing with them so much was like showing them
what to do and how much to do it at home,
and then you know, stim definitely some hands on where
where needed. Some people who were super swollen we could
elevate and do like some soft tissue that was not
ruled out for sure, but a lot of the people
that we see virtually at least in the beginning, we
(28:56):
do also recommend having a person in and even if
it's just once a week or once every other week
in the first couple of months for those types of things,
monitor for infection, anything like that. But I just I
realized that I was doing like pretty much no hands
on and so then essentially when we started to build
(29:18):
out what early phases could look like virtually, and again
not everybody's comfortable with it, It's totally fine. We you know,
I have a whole instruction the thing in terms of
how to use stim and a suggestion for one that's
affordable to use at home. We have suggestions for compressions leaves,
(29:38):
we have suggestions for BFR cuffs like things that in
the early phases. Again, once I teach somebody how to
use it, then I can't do it for them. They
just need to to actually do it. So I think
after a realizing was possible, then actually seeing how it
worked for people, and the feedback in terms of this
(30:02):
has been I don't know if I could have gone
to a clinic and been as successful, because eventually what
happens in early post off is it just fits into
your gym schedule. And so naturally the people that do
really really well with this type of setup, they're consistent,
they communicate with us regularly and well, so that we
(30:22):
know how to you know, manipulate the program based on
where they're at life wise, because life will throw stuff
at you, and they're already engaged in some sort of
regular physical activity and or the gym because essentially then
they just plug and play and we take care of
what they're doing in the gym. So that has been essentially,
if I were to describe it simply, that's kind of
(30:44):
how it has evolved. And then when we get to
later stages, you know, especially for a field or a
court sport athlete, they have sessions programmed that are on
a field or on a court, and they have drills
to do, we totally recognize and tell them that this
is not reactive. Essentially, we eventually need to do this
phase of some predicted stuff before then either adding a
(31:07):
partner and doing some reactive stuff or having you have
some modified participation with other people in a team. And
again that was another piece that I wasn't able to
do in the clinic because I can't, like liability and
legality wise, go to a field with someone on the
company's time in case anything were to happen. So in
(31:27):
these situations, again I recognize they're signing off liability wafers,
that this is not this is coaching. This is not
like you know, we're not building codes things like that.
So I recognize that's an advantage there because people have
to understanding going in. But for the right people and
the people that are kind of you know, bought into
the process, they do really well, oftentimes better than potentially
(31:52):
they would have done in just a regular clinic quick break.
Speaker 1 (31:54):
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Speaker 3 (31:59):
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(32:40):
on Instagram and receive your free breakdown on the model. Yeah,
it sounds like this removes a lot of the barriers
that we mentioned earlier, and it kind of provides the
individual who's faced the injury that way with almost like
a guide along their journey that way. And you know,
I think that's essential to note is you know, when
I graduated school, I looked at ACL rehab and I
(33:03):
was like, Oh, I have to do all these things
and I've got to do X, Y and Z and YadA, YadA, YadA,
And it's like, no, in reality, I just have to
act as kind of like the Google Maps steering someone
along the journey. It's not me doing the work. Ultimately,
you know, if you're the patient going through this, you
have to put the work in yourself and you just
need someone to show you what to do, what not
(33:24):
to do, how much to do, and kind of answer
those questions and guide you along the path. And to
the point you made about the communication, I think that
is so so undervalued how important communication and just overall
support is in this process, because you know, as you mentioned,
when you face an injury like this, part of your
identity is kind of pulled from you. Maybe you like
(33:45):
going to the gym, and now you're not able to
go to the gym and do all the things that
you like to do, or maybe you're not able to
go to the field and play sport the same way
that you were not that long ago. And I think
the more that you're able to kind of lean into
and tap into those support systems and the more allable
they are to you, the better off your outcome is
going to be. And I think that's where it also
(34:05):
helps having you know, the ability to work with someone
who has done this for you know, years and years
and years, helped hundreds of other people because they get
this experience and notice common trends with other athletes, or
you know, they see things that have worked for other
people that they can kind of like guide you with.
Or one of the things I'll do with people is
(34:26):
if they're really struggling, I'll reach out to some of
my former patients and ask them, hey, look, I know
you're busy, but would you mind giving twenty minutes just
jumping on a phone call with this person and talking
with them a little bit about what you went through,
what your journey looked like, and that was a huge
motivating factor to even just bring athletes on the podcast
and kind of shed some light on this space of
(34:48):
you know, whatever, you know hard times that you're facing
and your rehab journey, know that you're not alone, know
that other people are there. It does get dark sometimes,
it does get really challenging some tis, but know that
you're able to push through it. But to your point
in the communication, again, I think that is so undervalued
and underutilized in this and I just really like that
(35:09):
process of giving the person the autonomy to go at
it kind of, you know, independently a little bit, but
with the guidance and the guide rails up so that
they know where to turn, how fast to go, and.
Speaker 3 (35:22):
So on that way.
Speaker 2 (35:23):
Yeah, I would say that that is and it's always
been a strong bias of mine, the trying to understand
but also shout from the rooftops whenever I can about
the psychological impact of this injury. It's crazy to me
that it's still like, you know, it's talked about in research.
(35:44):
There's some pretty robust research to support its impacts even
on both the long term outcomes in terms of return
to sport rates, like you talked about it being super low.
The psych side is a big is a big part
of you know, we think, Okay, people just aren't getting
strong enough or you know, but I mean on I
(36:06):
am the poster child. I did not return from my
sport because I was literally too scared. And there's no
reason that I shouldn't have. I was seventeen, you know
what I mean, Like, there's no And I think all
the time about how how many people out there are
like me, had my situation, where had they had different guidance,
what could their athletic careers have looked like? And so
(36:29):
I don't want, you know, part of what I'm hell
bent on is like I don't want that situation to
be the reality for anybody that we work with, or
at least, like you know, it is possible sometimes with
complications or whatnot, that there might have to be a
slight lower level of return, but that they should still
be able to return. All to say, the communication piece
(36:53):
has allowed I've found in terms of there's technically been
a higher frequency sometimes even a little bit of a
deeper level of communication virtually, which sounds backwards. But that's
been a pleasant, like good surprise for me in this medium,
and it has allowed me and us to pick up
(37:15):
on some things mentally that I don't mentally nutritionally. It's
another passion of mine in terms of like relative energy
deficiency and sport with a lot of the younger female
athletes that I have seen and do see, I just
I've been really, you know again, pleasantly surprised. Not that
we that you want to come across things that are
(37:38):
you know, on the darker side of things, but it
does happen. This is a this injury changes your life.
It's not an exaggeration. So I do feel as though
the kind of more frequent touch points that we've actually had,
like asynchronous la er virtually has allowed us to pick
up on some more things. That's allowed me to refer
(37:58):
out to sports psychology register or sports dietitian and honestly,
for again, I know it comes with being able to
afford and have access to those things, but a lot
of times it's a lot more affordable than people think,
especially in true necessity, so you know, it's it's resulted
(38:19):
in adding potential other team members as person's recovery that
they that I think could really make or break their outcomes,
and that feels good too.
Speaker 1 (38:30):
Yeah, making it more interdisciplinary in nature. And it's so
interesting that we call this field physical therapy because, as
you alluded to, a lot of the times, it's not
just physical in nature. And I'm just like you, looking
for other individuals to kind of get involved in the
care of the person that I'm working with that way,
(38:51):
and going back to what we talked about earlier in
the importance of you know, if you're a patient or
an athlete who's faced one of these injuries that way,
you know, don't be afraid to get the second opinion,
don't be afraid to interview your rehab providers in all
that way, but also build a team around you. You know,
build your team not just of your PT and your surgeon,
but you know, if you're at a university or a
(39:13):
school that way, don't be afraid to get your AT involved.
In fact, please get your AT involved. I will always
advocate for that. Get your strength coach on board. See
who else you have access to if you're on campus again,
you might have access to a dietitian already, you might
have access to sports psycho or chiropractic or some of
these other disciplines already. And if not, you know, kind
(39:35):
of go about thinking about it. What pieces to this
puzzle might I need and where can they come from?
You know, can I find these people through the power
of the internet. Can I find some of these people
in person? What makes what makes the most sense to you?
And again, you can leverage the conversations or the experiences
of other people, because if there's one thing I've found,
(39:55):
everyone knows someone who's torn their acl So don't be
afraid to reach out to the people, ask them questions
went well, what didn't go well?
Speaker 3 (40:03):
What might you.
Speaker 1 (40:04):
Consider doing differently if it was to happen again that way,
And try and leverage that as a learning opportunity for
yourself to make sure that you know, again, if you're
unfortunate enough to face one of these injuries, that you
get it right the first time around. But you know again,
I just cannot emphasize enough that importance of building that
team of people around you and having your support group
(40:24):
built up as well to kind of help you there
are any kind of challenges and obstacles that might come up
that way. And it sounds like from your own personal
experience stuff. There's challenges and obstacles that came about for you,
and it's one of those things now that has got
to be so empowering and impactful for you to be
able to take what has happened to you and turn
around to make sure that it doesn't happen to anyone
(40:47):
else in this quote unquote next generation if you will.
Speaker 2 (40:50):
Yeah, there's certain things that are totally out of my
control and some people's you know, personal control with their
injury like anything else. But one thing that they will
not have happened if they work with me or us
is you know, not feeling supported, feeling a little bit
lost in terms of like where they are, where they
(41:13):
should be going. Like, those are things that are built
into my being, our systems. You know, I recognize I'm
one person and a small team and definitely, you know,
in my lifetime hope to have a bigger impact in
some way. But like you know, at the very least
(41:34):
at the end of the day, that's what I can
guarantee that it's it's not going to be a situation
like it was for me. And that being said, there's
also a lot of people that we get kind of
coming to us later on, like let's say it was
me at age nineteen instead of seventeen, and like still
(41:55):
probably in the window where I can have made some
significant progress, but those options just didn't exist, And so
those are sometimes just as fulfilling because people are at
a stage where they've kind of given up or kind
of like written off any possibility of getting back to
this activity, or you know, they've already kind of settled
(42:18):
to not doing a sport, which depending on the situation,
I may or not agree with, you know, depending on
what they have going on at that point, like that
far out. But I am a very strong believer that
there's still it's almost never too late in terms of
making some significant progress with the right guidance. And essentially
(42:38):
again I would be a good example of that in
terms of it was probably ten years later for me
that I even kind of like really got into and
like regular heavier strength training like and that has made
the world of difference. I can't I would be at
very high risk going back to basketball right now. However,
(42:58):
like I do most of the things that I want
to do. I run, I left, I can be active
and agile with my nieces and nephews, like if I
really wanted to play in like a chill adult league,
I probably could, you know, like nothing, nothing crazy, but yeah,
that's it's It's always kind of at my core in
(43:19):
the back of my mind with whoever I work with,
and I, you know, again, I recognize that that's potentially
an advantage or a way that I'm able to really
connect well with people, but I wouldn't use it any
other way.
Speaker 1 (43:38):
So now, one hundred percent, ultimately we take what has
happened to us and use it as a way to
you know, again, empower others and better their own lives
that way. And I realized that the ACL and complex
knee injuries and really just sports reab in general is
something that you're extremely passionate about, and I know that
you and I can talk about it all day long
(43:59):
that way. We could go on for another hour or
two and still not even cover everything that there is
in this space that way. But I also realized that
you have so many incredible resources and offerings, and you
help people you know that are facing these injuries every
single day, day in and day out that way. So
for people who want to learn more and find more
(44:21):
that way, where can they find more about you online
and so on that way.
Speaker 2 (44:25):
Yeah, definitely, So I admittedly like true and true millennial.
So I never really got into TikTok or Twitter, although
Twitter x whatever, I don't really know what it's called. However,
I am most usually on comfortable with an active on Instagram.
Steph Allen dot TPT last end of last year, only
(44:49):
took three years into business. But I actually created a website,
so that's just ACL resolve dot com that has a
lot more information in terms of our team kind of
of you know, core values philosophy, a little bit of
information in terms of how we got started or what
we what we offer, pricing, all that kind of stuff.
(45:13):
So a lot of times people people will start there
because it's a little easier, and yeah, I'm also I
know we didn't really talk much about it, but also
a lead mentor and co founder for Clinical Athlete, which
is kind of you know, we talked about raising the
floor in ACL rehab. Essentially that's our other husband and
I and a couple of other co founders or their
(45:33):
sort of life passion is just generally raising the floor
in physical therapy in general, and so we do some
mentoring for clinicians and coaches and hoping to kind of
build that up over the next couple of years and
make an impact there. And that's that's just clinical Athlete
on Instagram as well.
Speaker 3 (45:51):
Yeah, that's incredible work.
Speaker 1 (45:53):
And you know, it's so great that you bring that
up because I think everyone, I don't care what you know,
subset of pt you work, and feel like everyone needs
some kind of mentor or coach or someone that they
can lean on themselves that way, because there's always going
to be a case that doesn't go like you expect
it will, or doesn't just present like the books said
(46:13):
it would, and you get a little confused when that happens,
and it's nice to have someone that you can go
to for an outside perspective. And you know, just as
we mentioned it's important for the patient to build up
their own team around them, it's just as important, if
not more important, for the clinician to do the same thing,
because again, no one knows everything, so when things just
(46:34):
don't sit right with you, you get that gut feeling.
It's nice to know who you're going to turn to
and have some kind of curriculum too, to kind of
guide you towards that higher status as a clinician that
way and kind of learn more because as I'm sure
all of us know, the you know, the knowledge is
advancing far faster than I can keep up most.
Speaker 3 (46:52):
Of the time.
Speaker 2 (46:53):
Yeah, yeah, absolutely, We're very principles based, not necessarily methods.
So the methods are many, right, Like you guys use isofit,
which is like, but again, in order to effectively use
something like the isofit devices, which are great, you need
to have the understanding of how isometrics work, how they
(47:15):
fit into a strength training program, and all those are
our principles based clinical reasoning. And so that's again where
we at least feel like this is no knock on
schools or curriculum. They have to fit so much in
but it we're never really able to kind of go
the layer deeper in terms of why are we doing things,
(47:38):
you know, why do I make these decisions, what is
impacting these what do I want? What KPIs would I test?
How does this you know, fit into programming? Because essentially
we are for at least for and I will clarify
this like in the ortho world, in the general like
kind of sports ortho pt world, we are like coaches
(48:01):
and so in terms of you know, especially with potentially
seeing people less frequently because of insurance restrictions, Like we
need to have a kind of grander planner program for
most people, and that's just not something that it's not
something we get in school.
Speaker 3 (48:18):
I love that point so much.
Speaker 1 (48:19):
It's not just the methods, it's about the underlying principles
that guide and shape those decisions.
Speaker 3 (48:25):
In the first place.
Speaker 1 (48:26):
And it's so interesting because I see a lot of
people debating the methods but really doesn't matter a lot
of the time. A lot of mark like there's twenty
different ways to do the same thing. Pick one that
you like, get the results, understand the principles, and it's
going to take you far. So I love that point, Steph.
I really appreciate your time. I know you're a crazy
(48:47):
busy person with so much going on all the time.
That way, I just really appreciate your time and the
insights that you're able to share with us. That way,
I'm looking forward to future conversations with you.
Speaker 2 (48:58):
Yeah, for sure. Thank you for having me down this
fun
Welcome back to another episode of the Brown Performance and
Rehab Podcast, powered by Isofit and Firefly Recovery. Isofit is
my go to for all things isometric strength training. For
more on Isofit, be sure to check out isofit dot com.
Episodes like this are made possible by Firefly, the official
recovery provider of the Brown Performance and Rehab Podcast. For
(00:22):
more on Firefly, be sure to check out Recovery firefly
dot com. This episode is powered by doctor Ray Gorman,
founder of Engage Movement. Learn how to boost your income
without relying on sessions. Get a free training on the
Blended practice model by following at Ray Gorman DPT on Instagram.
Joining me today on the podcast is Steph Allen. I
(00:44):
had the pleasure of meeting Steph back in February at APTA,
and I really appreciate all the amazing work she's doing
in the space that way, especially around the ACL and
just elevating the state of rehab in general, and we
discuss all of that and more in this episode today.
This is an amazing conversation with Steph. Really appreciate her
(01:06):
time and highly recommend you check out her page and
all of the amazing stuff she's doing in the space.
If you haven't already enjoy Steph, welcome to the podcast.
I'm super excited to work with you today. In a
huge shout out to our mutual friend Katrina for helping
us get connected for people who aren't familiar with you
and all the incredible work that you've been doing in
the clinical space, in particular surrounding the complex knee and jury.
(01:28):
Would you mind filling people in a little bit about
who you are and all the great work that you've
been doing.
Speaker 2 (01:33):
Yeah, I appreciate that, and one hundred percent shout out
to Katrina, Missy Katrina. Yeah, I'm excited to be here.
I crazy to think about it, but I've been a
PT for eleven going on twelve years now. It's like
kind of wild to think about. I feel like, I know,
like just finished residency and was like doing travel PT and.
Speaker 3 (01:57):
Like not really knowing what I was doing.
Speaker 2 (01:59):
For all you people out there, don't worry. We know
enough of what we're doing when we're new grads that
you're fine. But yeah, so, I mean, there's it's a
much longer story, but essentially I was in, I did
a residency, then did travel PT for a couple of years.
Then I was in Boston for almost seven years, had
a really cool private owned sports Ortho clinic and really
that is where I kind of like dove deep honed
(02:22):
my skills, got a lot of practice with mostly ACL
but really all knee injuries, and was lucky that our
set up at that clinic although you know, moderate volume,
not like a super crazy high volume, but you know,
probably middle of the road. But in general how we
were able to treat was supported in terms of being
(02:45):
able to deliver you know, high value care, and so
that is I got a lot of practice, a lot
of reps at that clinic in Boston, and then you know,
life and career is funny. There was just some some
things that I need to needed to change, and namely,
you know, when most of your caseload is an ACL
(03:06):
injury or some other you know, complex or longer term
rehab situation of the knee, I was feeling a little
bit like my hands were tied in terms of I
was programming for all these people outside of their sessions,
knowing that you know, the most they were seeing me
was twice a week. They were needing to do so
much more right and we'll probably get into some of
(03:28):
that in terms of, you know, how the rehab process
for really highly active people probably needs to look a
little different after these injuries. So it was just a
real quick uh I would call it burnout, but really
just kind of like you know, programming for people outside
of sessions, also doing progress notes and regular notes, and
it just I couldn't bring all of me to the
(03:51):
table most days, and I didn't like that, so I
ended up going down to part time and then you know,
wouldn't have guessed it, but ended up starting my own
thing virtually. That is, that's been almost four years now,
and with some prospects, we're moving back generally to the
Boston area in the next year and hoping to try
(04:12):
to do something hybrid. So that's on the horizon, meaning
like a mix of virtual and in person. I don't
know exactly what that looks like yet, but yeah, that's
where I'm That's where I'm at currently and just you know,
continuing to try to learn.
Speaker 1 (04:27):
Yeah, congratulations on the future return to Boston, and what
an incredible journey and just a wealth and knowledge and
experience you have from your years as a clinician that
way and It's interesting because you kind of hit it
hinted at this issue that we see in the clinical
practice space, especially with athletes that are facing some of
these complex knee injuries like ACL or ACL and meniscus
(04:50):
injury that take nine to twelve sometimes even longer from
a month's standpoint, to get back to where they want
to be where you know, maybe they don't need to
see their PT on a regular basis anymore, right, But
there's multiple sides to this story. There's the patient who
is frustrated by the fact that they're only able to
see their PT once or twice a week, or maybe
(05:12):
they've got a whole lot of hitting costs that they
have to deal with from an insurance standpoint. I just
spent an hour this morning actually dealing with that with
someone where she got hit with some surprise bills from
almost two years ago, which is just insanity to think about,
but it happens more often than I think we realize.
So we've got this issue for the patient not getting
(05:33):
access to the care that they need and getting hit
with some surprise bills. And oh, by the way, even
if they are authorized to get care and they're seeing
care from a PT three times a week. There's then
the question of is the PT experienced in working with
this kind of injury, because unfortunately, our outcomes, regardless of
(05:53):
what level of athlete you are professional all the way
down to middle school, high school, are not as good
as they should be. In my opinion, I have no
issue throwing our profession under the bus for this. But
you know, we look at that one in three injured
ACL patients that don't return to sport, and I just
can't help but wonder if that number should be a
little bit lower, if that number should be a little
(06:15):
bit better, because maybe, you know, clinicians, maybe we need
to look ourselves in the mirror sometimes and say what
could we be doing different or what could we be
doing better. But in defense of the clinician, as you mentioned,
sometimes you've got a lot of patients to work where
you have a lot of things going on, and it
could be very very difficult to try and you know,
pour from a cup that's full, if you will, when
(06:38):
you're constantly emptying your cup over and over and over again,
balancing the demands of clinical practice and all these other
life demands that I feel like are not discussed enough
that way. So we kind of find ourselves in this
weird problem area for the patient who's faced a complex
knee injury, where there's a lot that they need, but
unfortunately it seems like the current system that we have
(07:01):
in place doesn't necessarily provide the best for them or
provide what's necessary to get them all the way back
to return to sport the majority of the time. And
maybe I'm crazy for making those claims, but I just
feel like that's kind of the current state of you know,
our healthcare system and providing for the athlete following a
complex knee injury that.
Speaker 2 (07:22):
Way, yeah, I think, And it's it's not only a
complex knee injury. There's definitely other I think potentially more
chronic injuries as well. And then it's it's interesting they
almost kind of I think, not to categorize an ACL
injury or a complex knee injury as chronic. But technically,
(07:45):
if you're going by the definition of chronic, the amount
of time that it takes to you know, by definition
fully recover, that's a chronic issue. It's like it's there
are multiple phases. It's almost like, in my mind, a
chronic issue that you just know going in is going
to be chronic, unlike you know, an ankle sprain or
(08:07):
something where you've had some naggy shoulder pain that you
go in for and you're not really sure how long
it'll take to sort of improve. You know, some people
things end up being more chronic, others not. Like this
is a situation where you know, to your point, like
you can pretty much guarantee that it's going to be
at least nine to twelve months, especially based on research
right now, and that is without any setbacks, without any
(08:30):
like hiccups or anything, and often with a plan and
a provider that you know is experienced, because it just
does seem to take that long. And you know, that's
even aside from different graphs, because different graphs tend to
take a little bit longer. It's probably a whole different conversation.
But yes, to your point, I think that unfortunately it's twofold,
(08:54):
at least in my experience the system itself. Again, I
was lucky to be in a place that really allowed
me to treat how I believed, but it was still
every thirty minute sessions and a lot of times I
was just needing to see two to three kids at
a time after school, which is like okay, was you
(09:17):
know in some ways good, like they could do some
things together depending on what stage they were at and whatnot.
But that combined with the amount of space and equipment
we had, you know that there was definitely some limitations there.
And then again I knew that they needed to be doing.
Most of these at that time were high school kids, right,
so they're going back to a sport where or we
(09:39):
are working to try to prepare them to be doing
something sport related, very active, probably six days a week.
And if they spend a year doing things twice a
week and maybe one other day, if I try to
hold them accountable for one other day on their own,
there's a big gap there, right, So I was running
into that program for people outside their sessions, like I
(10:02):
was saying, And so that's that's in the case of
a provider that is sort of specialized in that area
and knows what they need. In a lot of cases,
especially at higher volume places, they're seeing fifteen twenty people
a day, maybe like that's not an exaggeration. So there's
no way that that pta as a human has the bandwidth,
(10:24):
nor should they if they want to take care of themselves.
And actually, like eat dinner and sleep between shifts that
they're going to like write programs and be able to
kind of like correspond the email with people between sessions.
So definitely system is one thing. I think the other
issue is, you know, we are we're generalists. When we
(10:47):
leave school, I can't recall diving deeper than the anatomy
and healing timeframes of acial injuries in actual like didactic
work in school. There's just not not really time for
it because we need to learn all the things, which
I totally understand. But similarly to how I would not
(11:09):
feel comfortable with somebody after a finger tendon surgery, you know,
you tend to if you have an interest in an area,
sort of like niche down, really dive deep understand everything
about it that you can. And that's just not necessarily
the norm with anybody at a general sports ortho clinic.
(11:29):
And so I think that people are going to the
place that their insurance covers and where their surgeon sends them,
but it isn't always necessarily going to be the best
fit for them, and people don't realize that they have
call it health literacy or whatever, just doctor patient dynamics.
(11:50):
You know, they don't necessarily have the knowledge and maybe
confidence to basically shop around for a provider.
Speaker 1 (11:58):
Yeah, And it's interesting you say that about shopping around
for a provider, because I've noticed patients more and more
are doing that with surgeons. They're getting second opinions, sometimes
even third opinions. And I would love to see something
similar from a PT standpoint or a rehab standpoint. I
would love to see an evolution in the system where
it's almost like the patient gets like a like almost
(12:20):
like a Q and a kind of session with the
PT almost like, Hey, what's your experience working with patients
that have had similar injury to mine or the same
injury as mine? What kind of outcomes have you seen
from the surgeon that I've picked that way, do you two.
Speaker 3 (12:34):
Work closely together?
Speaker 1 (12:35):
Like there's so many different factors to consider there, But
ultimately it becomes a question of how do we reach
the people who possibly don't even know they need to
be reached, and you know, are just kind of following
the advice that's given to them and doing what they're
told and then you know, unfortunately finding themselves in a
very difficult situation later down the line that way, And
(12:57):
I think ultimately the more we raise the floor for
everyone and kind of raise that bottom line standard of
what we're looking for, the better it's going to be
for everyone involved that way. And you know, I know
you talk about this all the time, and I see
you post about it all the time as well. There's
a lot of common trends that I think we see
missing in athletes and patients who have underwent knee injuries
(13:19):
or even injuries in other areas. Like you mentioned, that
just seem to be common theme themes that come up
over and over and over again, and it's like, hey,
if nothing else, maybe we could start here, Maybe we
could start with the big rocks in this jar of
life instead of arguing over a little small details like
the sand in the jar, Let's you know, tackle some
big rocks if nothing else. And you know, at least
(13:40):
from one of the things that I've seen from a
lot of athletes who struggle mid to late stage ACL
in particular, a lot of them do not own knee extension,
whether that's you know, not getting full extension range of
motion back or not getting good knee extension strength back.
Regardless of what it is, there's some kind of issue
you that ensues with the extension, and I know you
(14:02):
mentioned different graph types, and that seems to be regardless
graph type quad, bTB whatever, the quad is very difficult
to bring back. So, you know, if nothing else, I
think that it'd be awesome to see our standard and
framework kind of evolve in a way that says, hey,
look at the minimum, we need to make sure that
we're getting people back to a point where they have
(14:22):
full range emotion equal between the left and the right,
and they need to have really really really good strength
and not just you know, oh well, it feels strong
to my hand, like, I would love it if we
could find a way to evolve that into something a
little bit more objective, if you will, not to say
it's not objective, but I would say it's just a
little bit inconsistent between what you might say is strong
(14:44):
versus what I might say is strong. And I think
the more that we kind of have the conversation around
that baseline framework and elevating the floor for everyone, the
better we're going to see our outcomes get across the board.
Speaker 2 (14:57):
Yeah, I do think that, you know, you mentioned a
couple of questions that people can ask in terms of
when they're kind of shopping around. I think the analogy
or the comparison of you know, we don't think twice
about getting a second opinion with a surgeon, like what's different?
In fact, I would, you know, argue it would be
more important to get a couple of opinions with the
(15:20):
PT because they're going to be spending all the time
with you. So yes, I definitely agree with that. I
think that the one of the other things could double
as a question that you ask as well. But in
terms of raising that floor and kind of having you know,
I think of certain things being sort of bare minimum
in terms of bareminium necessities. Essentially, for if you are
(15:43):
going to consistently, if you are a clinic that is
going to consistently see post top patients, particularly knee injuries,
that are going to be returning back to any form
of active lifestyle, you need a way to objectively test
their strength. And that doesn't mean that you need to
go out and buy a huge isokinetic machine that's like
(16:03):
fifty grand. You can buy a tin deck force gage
that's two hundred dollars. It was two hundred dollars like
a couple of years ago. But either way, like something
very in terms of like a clinic expense very affordable
business right off, and you know, having either a clinician
that works there that knows, or have somebody come in
(16:23):
to do some sort of brief traits, very user friendly
type of thing. Most clinics have something sturdy enough to
set it up on. You know that to me is
like to your point, it's you. You literally I feel
strongly enough about it to say that it's like, well,
borderline mail practice to be progressing somebody through ACL rehab
(16:48):
without knowing what their quad and hamstring torque to bodyweight
ratio and LSI limb symmetry are. Like, it's just it's
so accessible now, it's like almost not excusable, if that makes.
Speaker 3 (16:58):
Sense, makes a lot of sense.
Speaker 1 (17:01):
And I mean I completely agree with your point, right Like,
you know, before you progress someone to the next stage,
it would make sense to have.
Speaker 3 (17:08):
Them earn that right to progress.
Speaker 1 (17:11):
And I almost think about it this is probably a
terrible analogy, but I think about it very similar to
how we look at like the school system, right, Like
you don't just jump into PT school and go right
into you know, the most advanced courses, the eight hundred
level courses. Day one, you earn the right to get there.
You take your general biology and your general physics, and
(17:33):
if you're like me, you curse out every single day
of it because what do I need to know about
that stuff to be a pt. But ultimately you put
your time in and you put the work in. There's
a lot of checkpoints along the way to make sure
that you've made the progress that you need in order
to earn that right to progress. Now, obviously everyone's going
to debate on what that correct assessment is and if
(17:55):
it's actually telling you what you need to know, but
we could have that conversation a separate time. In general,
I think there's something to be said about having that
phased progress or that phased process that has checkpoints along
the way where you stop, you pause, you test some stuff,
and you say, are we where we want to be?
Are we where we need to be? Are we good
(18:15):
to progress to the next level? Or do we maybe
need to stay here a little bit longer and earn
that right to progress later on?
Speaker 3 (18:22):
Yeah?
Speaker 2 (18:23):
That's I mean, you know, we refer to it as
like criteria based progressions versus timeline. Unfortunately, there's still a
pretty pervasive sort of societal and also in the medical field,
like expectation that like I'm going to run out twelve
weeks and I'm going to start sports stuff at six months,
(18:44):
and some people can do that. I can tell you
from working pretty solely with almost all ACL knee injuries
for the last I don't know, at least six years,
probably more than that. It's rare and the just I
(19:04):
think if people had the expectation of kind of more
what you were alluding to in terms of, Okay, I'm
gonna work my butt off in each stage at a
certain timeframe. We're gonna test some things to see exactly
where I am. The numbers don't lie, right, So like
if if the numbers are, you know, not necessarily where
(19:24):
we need them to be, then it doesn't necessarily mean
that we can't progress in some other ways. But in
certain areas let's say it's strength, let's say it's range
of motion or whatever, we got to kind of stay
at this level a little bit kind of work, you know,
side to side or laterally versus increasing anything, and then
you basically kind of like then earn the right or
(19:47):
the milestone or checkpoint to continue. And that in and
of itself, though it sounds super annoying. I try to
explain to people, like I'm a big expectation setting person
because I think of people go into this injury, let's say,
either whether they had the injury themselves or somebody else
that they know has had it, or they know nothing
(20:10):
about it, but then they do a huge Google dive
right when they get injured, as I probably would too
if I didn't know, and then they go in again.
Now with some biases everyone does, or some expectations, and
a lot of times those expectations are not going to
be conducive to them having a real good time mentally
(20:31):
because they're not realistic. So unfortunately that does oftentimes fall
on us to like reset those expectations, make sure everybody's
on the same page. But you know, that whole process
of testing, seeing where we're at modified, you know, the
testing is just as much for us as well. We
need to tweak the programming based on that and make
(20:53):
sure like, okay, you know, when we get into some
later stage, maybe like rate of force development is really
you know, not coming along for whatever reason, let's revisit
that and see where we can maybe make a greater
focus of that in the programming. So you know, like
being able to see the testing is like, this is
(21:14):
literally just information that just tells us where to go.
It doesn't mean I'm failing, It doesn't mean I'm and it.
You know, it does kind of dictate your pace a
little bit, as it should I think if it was
seen a little bit more in that light versus you know,
a test you have to pass and it tells you
what kind of person or athlete you are. And a
(21:35):
lot of times, sometimes or a lot of times, people
are tested and then the clinician or even surgeon will
kind of give a little like wiggle room and still
allow them to continue to do stuff. If you let
that happen once, then the testing later on it just
just doesn't hold the same clout for the person. And
then a lot of times people are ended up, they
(21:55):
end up being cleared probably sooner because they're like close enough.
And that is a whole other reason. In turn, Like
there's many reasons why I think the re injury rate
is really high, but that's another one that I don't
think people talk about a lot.
Speaker 3 (22:09):
No, one hundred percent.
Speaker 1 (22:11):
And you bring up such an interesting point too, in
the sense that the testing can be just as much
for the clinician as it is the athlete as you mentioned.
And I think that's something else that is not discussed
enough is no one gets it right one hundred percent
of the time. No one has every answer for every
person every time. Everyone's a little bit unique and a
(22:31):
little bit different.
Speaker 3 (22:32):
And how I might you know.
Speaker 1 (22:33):
Go about loading One person's squad might be different than
the next one, for example, So we can't just use
the same things and expect it to work for every
single person that walks through our doors. That way, we
have to add that individualization element to it, and sometimes
we have to adjust as we go and realize that, hey,
you know, maybe this exercise isn't producing the response I
(22:56):
want to and kind of course correct ourselves. But to
your point, the more you test regularly, the more you're
going to kind of be able to kind of assess
those things in the moment. Right If you don't do
any kind of testing on knee extension, for example, until
nine months out, then you know, you could have potentially
prevented a huge strength deficit if you tested maybe four
to six months out and bought it a little bit
(23:18):
earlier instead of getting that far out and testing for
the first time and I think it makes the decision
process a little bit more easier when it does come
time to talk about return to sport or return to play,
right like, instead of it being just one snapshot in time,
maybe instead we kind of build it out as a continuum,
a progression, and we're able to get data points that show, hey,
(23:39):
this is where we were, this is where we need
to be, and now we've met that, you know, end
goal of where we need to be, and here's how
we got there.
Speaker 3 (23:46):
Right.
Speaker 1 (23:46):
You're almost able to map it out and look at
the person that you're working with almost like their own
case study, and kind of create this like an equals
one research on their own case that way, And I
think it's really really powerful and impactful to do that
kind of stuff. But you know, as we mentioned, there's
a lot of issues in the space, but there's also
(24:06):
a lot of people such as yourself and your team
that way, they're doing phenomenal work and solving a lot
of these issues and having really great outcomes working with
people oftentimes not even getting to put hands on them
and getting really good outcomes as well, which I think
blows a lot of clinicians' minds because they feel like
they need to see it in person or they need
(24:27):
to put their hands on someone in order to tell
that you know, they're getting progress. But if you're able
to do it without seeing that person in person a
lot of the time, I'd be interested to hear more
about that. You know, how did you go about transitioning
from that in person to virtual based care, if you will,
And how have you been able to you know, meet
all these different criterion and you know, develop a framework
(24:51):
that is effective for you and your team that way
when you're oftentimes not even seeing a person in person.
Speaker 2 (24:57):
Yeah, I mean to be honest, I was without like
sort of unknowingly already doing it a little bit when
I was in the clinic, I was programming for people
with like Excel sheets and checking like you know, aside
the only thing that really wasn't happening that happens now
with like through ACL resolve, like through the business is
(25:21):
like video feedback. That was pretty much the only thing
that wasn't happening. And obviously we have a lot more
systems and accountability built in now, you know over the
last four years that the systems put in place really
do help a lot with that. But I think for me,
it was like other than kind of like the first
(25:42):
post at visit and maybe the first couple of weeks
and sometimes not even every session was I actually doing
anything with my hands. One of the reasons being, especially
if we're just taking acl for instance, you have the
injury itself, which is trauma to the joint, then lots
(26:03):
of swelling however long that you're doing ideally prehab, but
you know, between injury and surgery there's lots of swelling.
You're trying to get range of motion back, You're trying
to get the quad working, like going into surgery in
the best shape that you can. Then the surgery is
another insult to the joint again another inflammatory process, rightfully so,
because it needs to go in and heal everything. Potentially.
(26:26):
It used to be also that they would use ephemeral
nerve block in term for pain control. They're largely getting
away from that and using either aductor or some other
more local, less intense anesthetics so that you weren't also
getting the femoral nerve anesthetized that innervates all of your quads,
(26:47):
so that essentially was a third insult to the knee
and the quads. And then after surgery, you're trying to
you know, depending on the situation. Sometimes people were trying
to like crank into extension and flow. Like a lot
of people looked at nay Mars rehab on Instagram, which
was like comical because it was pretty much the quintessential
(27:10):
everything that you should not do, and so all of
that to say, like I'll land the plane here, but
like that knee is so hot oftentimes and inflamed at
the beginning. If I'm trying to manipulate it past really
what it's kind of willing to cooperate during a one
(27:30):
hour session. Maybe like they may be there with me
for one hour, but I'm really only one on one
for thirty minutes. We can better use our time. So essentially,
what I found myself doing a ton of was like
educating of like Okay, i will show you how to
do pateller mobes, I'll show you how to set up
a heel pop prop. Because what's going to need to
happen is this is going to need to be a
(27:51):
low and slow thing. You need to gently nudge that
knee and show it that extension is okay. You need
to nudge into flection. You should not be cranking on
it because what your body will do. It already thinks
that this knee is there's a catastrophe here, and it
doesn't want to The nervous system is just saying, like
I don't want to load this thing. I don't want
to move it. We need to protect, we need to
(28:12):
basically seize up. It's something Eric Meta talks a lot about.
He's one of my biggest mentors, and like your job
is to basically like give it lots of inputs during
the day, like, hey, we're going to like settle into
extension here, We're gonna you know, because it's going to
backfire on you. So essentially that coupled with the fact
that like, okay, when I realized in practice what I
(28:34):
was doing with them so much was like showing them
what to do and how much to do it at home,
and then you know, stim definitely some hands on where
where needed. Some people who were super swollen we could
elevate and do like some soft tissue that was not
ruled out for sure, but a lot of the people
that we see virtually at least in the beginning, we
(28:56):
do also recommend having a person in and even if
it's just once a week or once every other week
in the first couple of months for those types of things,
monitor for infection, anything like that. But I just I
realized that I was doing like pretty much no hands
on and so then essentially when we started to build
(29:18):
out what early phases could look like virtually, and again
not everybody's comfortable with it, It's totally fine. We you know,
I have a whole instruction the thing in terms of
how to use stim and a suggestion for one that's
affordable to use at home. We have suggestions for compressions leaves,
(29:38):
we have suggestions for BFR cuffs like things that in
the early phases. Again, once I teach somebody how to
use it, then I can't do it for them. They
just need to to actually do it. So I think
after a realizing was possible, then actually seeing how it
worked for people, and the feedback in terms of this
(30:02):
has been I don't know if I could have gone
to a clinic and been as successful, because eventually what
happens in early post off is it just fits into
your gym schedule. And so naturally the people that do
really really well with this type of setup, they're consistent,
they communicate with us regularly and well, so that we
(30:22):
know how to you know, manipulate the program based on
where they're at life wise, because life will throw stuff
at you, and they're already engaged in some sort of
regular physical activity and or the gym because essentially then
they just plug and play and we take care of
what they're doing in the gym. So that has been essentially,
if I were to describe it simply, that's kind of
(30:44):
how it has evolved. And then when we get to
later stages, you know, especially for a field or a
court sport athlete, they have sessions programmed that are on
a field or on a court, and they have drills
to do, we totally recognize and tell them that this
is not reactive. Essentially, we eventually need to do this
phase of some predicted stuff before then either adding a
(31:07):
partner and doing some reactive stuff or having you have
some modified participation with other people in a team. And
again that was another piece that I wasn't able to
do in the clinic because I can't, like liability and
legality wise, go to a field with someone on the
company's time in case anything were to happen. So in
(31:27):
these situations, again I recognize they're signing off liability wafers,
that this is not this is coaching. This is not
like you know, we're not building codes things like that.
So I recognize that's an advantage there because people have
to understanding going in. But for the right people and
the people that are kind of you know, bought into
the process, they do really well, oftentimes better than potentially
(31:52):
they would have done in just a regular clinic quick break.
Speaker 1 (31:54):
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Speaker 3 (31:59):
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Speaker 1 (32:00):
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(32:40):
on Instagram and receive your free breakdown on the model. Yeah,
it sounds like this removes a lot of the barriers
that we mentioned earlier, and it kind of provides the
individual who's faced the injury that way with almost like
a guide along their journey that way. And you know,
I think that's essential to note is you know, when
I graduated school, I looked at ACL rehab and I
(33:03):
was like, Oh, I have to do all these things
and I've got to do X, Y and Z and YadA, YadA, YadA,
And it's like, no, in reality, I just have to
act as kind of like the Google Maps steering someone
along the journey. It's not me doing the work. Ultimately,
you know, if you're the patient going through this, you
have to put the work in yourself and you just
need someone to show you what to do, what not
(33:24):
to do, how much to do, and kind of answer
those questions and guide you along the path. And to
the point you made about the communication, I think that
is so so undervalued how important communication and just overall
support is in this process, because you know, as you mentioned,
when you face an injury like this, part of your
identity is kind of pulled from you. Maybe you like
(33:45):
going to the gym, and now you're not able to
go to the gym and do all the things that
you like to do, or maybe you're not able to
go to the field and play sport the same way
that you were not that long ago. And I think
the more that you're able to kind of lean into
and tap into those support systems and the more allable
they are to you, the better off your outcome is
going to be. And I think that's where it also
(34:05):
helps having you know, the ability to work with someone
who has done this for you know, years and years
and years, helped hundreds of other people because they get
this experience and notice common trends with other athletes, or
you know, they see things that have worked for other
people that they can kind of like guide you with.
Or one of the things I'll do with people is
(34:26):
if they're really struggling, I'll reach out to some of
my former patients and ask them, hey, look, I know
you're busy, but would you mind giving twenty minutes just
jumping on a phone call with this person and talking
with them a little bit about what you went through,
what your journey looked like, and that was a huge
motivating factor to even just bring athletes on the podcast
and kind of shed some light on this space of
(34:48):
you know, whatever, you know hard times that you're facing
and your rehab journey, know that you're not alone, know
that other people are there. It does get dark sometimes,
it does get really challenging some tis, but know that
you're able to push through it. But to your point
in the communication, again, I think that is so undervalued
and underutilized in this and I just really like that
(35:09):
process of giving the person the autonomy to go at
it kind of, you know, independently a little bit, but
with the guidance and the guide rails up so that
they know where to turn, how fast to go, and.
Speaker 3 (35:22):
So on that way.
Speaker 2 (35:23):
Yeah, I would say that that is and it's always
been a strong bias of mine, the trying to understand
but also shout from the rooftops whenever I can about
the psychological impact of this injury. It's crazy to me
that it's still like, you know, it's talked about in research.
(35:44):
There's some pretty robust research to support its impacts even
on both the long term outcomes in terms of return
to sport rates, like you talked about it being super low.
The psych side is a big is a big part
of you know, we think, Okay, people just aren't getting
strong enough or you know, but I mean on I
(36:06):
am the poster child. I did not return from my
sport because I was literally too scared. And there's no
reason that I shouldn't have. I was seventeen, you know
what I mean, Like, there's no And I think all
the time about how how many people out there are
like me, had my situation, where had they had different guidance,
what could their athletic careers have looked like? And so
(36:29):
I don't want, you know, part of what I'm hell
bent on is like I don't want that situation to
be the reality for anybody that we work with, or
at least, like you know, it is possible sometimes with
complications or whatnot, that there might have to be a
slight lower level of return, but that they should still
be able to return. All to say, the communication piece
(36:53):
has allowed I've found in terms of there's technically been
a higher frequency sometimes even a little bit of a
deeper level of communication virtually, which sounds backwards. But that's
been a pleasant, like good surprise for me in this medium,
and it has allowed me and us to pick up
(37:15):
on some things mentally that I don't mentally nutritionally. It's
another passion of mine in terms of like relative energy
deficiency and sport with a lot of the younger female
athletes that I have seen and do see, I just
I've been really, you know again, pleasantly surprised. Not that
we that you want to come across things that are
(37:38):
you know, on the darker side of things, but it
does happen. This is a this injury changes your life.
It's not an exaggeration. So I do feel as though
the kind of more frequent touch points that we've actually had,
like asynchronous la er virtually has allowed us to pick
up on some more things. That's allowed me to refer
(37:58):
out to sports psychology register or sports dietitian and honestly,
for again, I know it comes with being able to
afford and have access to those things, but a lot
of times it's a lot more affordable than people think,
especially in true necessity, so you know, it's it's resulted
(38:19):
in adding potential other team members as person's recovery that
they that I think could really make or break their outcomes,
and that feels good too.
Speaker 1 (38:30):
Yeah, making it more interdisciplinary in nature. And it's so
interesting that we call this field physical therapy because, as
you alluded to, a lot of the times, it's not
just physical in nature. And I'm just like you, looking
for other individuals to kind of get involved in the
care of the person that I'm working with that way,
(38:51):
and going back to what we talked about earlier in
the importance of you know, if you're a patient or
an athlete who's faced one of these injuries that way,
you know, don't be afraid to get the second opinion,
don't be afraid to interview your rehab providers in all
that way, but also build a team around you. You know,
build your team not just of your PT and your surgeon,
but you know, if you're at a university or a
(39:13):
school that way, don't be afraid to get your AT involved.
In fact, please get your AT involved. I will always
advocate for that. Get your strength coach on board. See
who else you have access to if you're on campus again,
you might have access to a dietitian already, you might
have access to sports psycho or chiropractic or some of
these other disciplines already. And if not, you know, kind
(39:35):
of go about thinking about it. What pieces to this
puzzle might I need and where can they come from?
You know, can I find these people through the power
of the internet. Can I find some of these people
in person? What makes what makes the most sense to you?
And again, you can leverage the conversations or the experiences
of other people, because if there's one thing I've found,
(39:55):
everyone knows someone who's torn their acl So don't be
afraid to reach out to the people, ask them questions
went well, what didn't go well?
Speaker 3 (40:03):
What might you.
Speaker 1 (40:04):
Consider doing differently if it was to happen again that way,
And try and leverage that as a learning opportunity for
yourself to make sure that you know, again, if you're
unfortunate enough to face one of these injuries, that you
get it right the first time around. But you know again,
I just cannot emphasize enough that importance of building that
team of people around you and having your support group
(40:24):
built up as well to kind of help you there
are any kind of challenges and obstacles that might come up
that way. And it sounds like from your own personal
experience stuff. There's challenges and obstacles that came about for you,
and it's one of those things now that has got
to be so empowering and impactful for you to be
able to take what has happened to you and turn
around to make sure that it doesn't happen to anyone
(40:47):
else in this quote unquote next generation if you will.
Speaker 2 (40:50):
Yeah, there's certain things that are totally out of my
control and some people's you know, personal control with their
injury like anything else. But one thing that they will
not have happened if they work with me or us
is you know, not feeling supported, feeling a little bit
lost in terms of like where they are, where they
(41:13):
should be going. Like, those are things that are built
into my being, our systems. You know, I recognize I'm
one person and a small team and definitely, you know,
in my lifetime hope to have a bigger impact in
some way. But like you know, at the very least
(41:34):
at the end of the day, that's what I can
guarantee that it's it's not going to be a situation
like it was for me. And that being said, there's
also a lot of people that we get kind of
coming to us later on, like let's say it was
me at age nineteen instead of seventeen, and like still
(41:55):
probably in the window where I can have made some
significant progress, but those options just didn't exist, And so
those are sometimes just as fulfilling because people are at
a stage where they've kind of given up or kind
of like written off any possibility of getting back to
this activity, or you know, they've already kind of settled
(42:18):
to not doing a sport, which depending on the situation,
I may or not agree with, you know, depending on
what they have going on at that point, like that
far out. But I am a very strong believer that
there's still it's almost never too late in terms of
making some significant progress with the right guidance. And essentially
(42:38):
again I would be a good example of that in
terms of it was probably ten years later for me
that I even kind of like really got into and
like regular heavier strength training like and that has made
the world of difference. I can't I would be at
very high risk going back to basketball right now. However,
(42:58):
like I do most of the things that I want
to do. I run, I left, I can be active
and agile with my nieces and nephews, like if I
really wanted to play in like a chill adult league,
I probably could, you know, like nothing, nothing crazy, but yeah,
that's it's It's always kind of at my core in
(43:19):
the back of my mind with whoever I work with,
and I, you know, again, I recognize that that's potentially
an advantage or a way that I'm able to really
connect well with people, but I wouldn't use it any
other way.
Speaker 1 (43:38):
So now, one hundred percent, ultimately we take what has
happened to us and use it as a way to
you know, again, empower others and better their own lives
that way. And I realized that the ACL and complex
knee injuries and really just sports reab in general is
something that you're extremely passionate about, and I know that
you and I can talk about it all day long
(43:59):
that way. We could go on for another hour or
two and still not even cover everything that there is
in this space that way. But I also realized that
you have so many incredible resources and offerings, and you
help people you know that are facing these injuries every
single day, day in and day out that way. So
for people who want to learn more and find more
(44:21):
that way, where can they find more about you online
and so on that way.
Speaker 2 (44:25):
Yeah, definitely, So I admittedly like true and true millennial.
So I never really got into TikTok or Twitter, although
Twitter x whatever, I don't really know what it's called. However,
I am most usually on comfortable with an active on Instagram.
Steph Allen dot TPT last end of last year, only
(44:49):
took three years into business. But I actually created a website,
so that's just ACL resolve dot com that has a
lot more information in terms of our team kind of
of you know, core values philosophy, a little bit of
information in terms of how we got started or what
we what we offer, pricing, all that kind of stuff.
(45:13):
So a lot of times people people will start there
because it's a little easier, and yeah, I'm also I
know we didn't really talk much about it, but also
a lead mentor and co founder for Clinical Athlete, which
is kind of you know, we talked about raising the
floor in ACL rehab. Essentially that's our other husband and
I and a couple of other co founders or their
(45:33):
sort of life passion is just generally raising the floor
in physical therapy in general, and so we do some
mentoring for clinicians and coaches and hoping to kind of
build that up over the next couple of years and
make an impact there. And that's that's just clinical Athlete
on Instagram as well.
Speaker 3 (45:51):
Yeah, that's incredible work.
Speaker 1 (45:53):
And you know, it's so great that you bring that
up because I think everyone, I don't care what you know,
subset of pt you work, and feel like everyone needs
some kind of mentor or coach or someone that they
can lean on themselves that way, because there's always going
to be a case that doesn't go like you expect
it will, or doesn't just present like the books said
(46:13):
it would, and you get a little confused when that happens,
and it's nice to have someone that you can go
to for an outside perspective. And you know, just as
we mentioned it's important for the patient to build up
their own team around them, it's just as important, if
not more important, for the clinician to do the same thing,
because again, no one knows everything, so when things just
(46:34):
don't sit right with you, you get that gut feeling.
It's nice to know who you're going to turn to
and have some kind of curriculum too, to kind of
guide you towards that higher status as a clinician that
way and kind of learn more because as I'm sure
all of us know, the you know, the knowledge is
advancing far faster than I can keep up most.
Speaker 3 (46:52):
Of the time.
Speaker 2 (46:53):
Yeah, yeah, absolutely, We're very principles based, not necessarily methods.
So the methods are many, right, Like you guys use isofit,
which is like, but again, in order to effectively use
something like the isofit devices, which are great, you need
to have the understanding of how isometrics work, how they
(47:15):
fit into a strength training program, and all those are
our principles based clinical reasoning. And so that's again where
we at least feel like this is no knock on
schools or curriculum. They have to fit so much in
but it we're never really able to kind of go
the layer deeper in terms of why are we doing things,
(47:38):
you know, why do I make these decisions, what is
impacting these what do I want? What KPIs would I test?
How does this you know, fit into programming? Because essentially
we are for at least for and I will clarify
this like in the ortho world, in the general like
kind of sports ortho pt world, we are like coaches
(48:01):
and so in terms of you know, especially with potentially
seeing people less frequently because of insurance restrictions, Like we
need to have a kind of grander planner program for
most people, and that's just not something that it's not
something we get in school.
Speaker 3 (48:18):
I love that point so much.
Speaker 1 (48:19):
It's not just the methods, it's about the underlying principles
that guide and shape those decisions.
Speaker 3 (48:25):
In the first place.
Speaker 1 (48:26):
And it's so interesting because I see a lot of
people debating the methods but really doesn't matter a lot
of the time. A lot of mark like there's twenty
different ways to do the same thing. Pick one that
you like, get the results, understand the principles, and it's
going to take you far. So I love that point, Steph.
I really appreciate your time. I know you're a crazy
(48:47):
busy person with so much going on all the time.
That way, I just really appreciate your time and the
insights that you're able to share with us. That way,
I'm looking forward to future conversations with you.
Speaker 2 (48:58):
Yeah, for sure. Thank you for having me down this
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