How I Spent My Day

Remember when social media first started to become popular and people started posting on Facebook every little thing they did?  Like folded laundry, took a shower, went to the gym... nothing really out of the ordinary, usual everyday kinds of things?  Like today, my brother just re-posted his first Facebook post of each month of 2019.  How four people liked that is beyond me.  Or remember when AOL Instant Messenger had "Away Messages" that would automatically get sent back to anyone who wrote you because you were away from your computer?

One time in college, I had an "Away Message" up that was a quote from the band "3 Doors Down."  Here's a YouTube link to one of their hits, "Here Without You," in case you need a refresher. I don't remember the quote I used, but it was probably from this song.  Anyways, I had their quote as my away message and I probably didn't have proper punctuation to identify it as a song because my sister called me at 2AM and when I sleepily answered from my own bed in my dorm room, she asked "Who lives 3 doors down from you that you're spending all this time with?"  Ha!

Anyways, now that you are reflecting on all the simple things you used to post on your own social media or the things that annoy you when you read them from others, I'm going to tell you how I spent my day today. An Abby Play-By-Play for your reading enjoyment.  I'm sure you all want to know.

Today is Monday, December 16th.  I woke up around 7:30AM, before my alarm.  I usually don't need my alarm to wake up, so today was no exception.  I have Mondays off and was excited that I had signed up to watch the Breakthrough Summit, a digital leadership conference for women in sports.  If you missed it, you can still watch the replay by signing up here.

LaChina Robinson and Jill Ellis

The Summit kicked off with introduction from ESPN Basketball Analyst LaChina Robinson (Twitter @LaChina Robinson) interviewing Jill Ellis Head Soccer Coach for the 2019 World Cup Champions US Women's Soccer  National Team.  I didn't plan to live tweet quotes from today... but then the inspiring quotes just wouldn't stop coming.  Coach Ellis talked about her career path, things coaches should consider as they work towards the top, her experience working with outspoken professional athletes in the current environment where women are voicing their opinions, loudly, about the inequalities in opportunity, pay, the workforce, and so many other areas.  My favorite quote from this interview was Coach Ellis saying "If I'm the same leader today that I was two years ago, I'm failing."  The value of personal growth is enormous, and I heard her loud and clear.

At this point, I got out of bed and made a bowl of Frosted Flakes with Almond Milk and some grapes which I enjoyed while watching the next portion of the Summit. LaChina had an interesting discussion with a panel coming from three different sports backgrounds.  Dr. Jen Welter (Twitter @jwelter47) is considered to be the first woman who worked in the NFL when she joined the Arizona Cardinals Coaching Staff in 2015 after a successful career as a Pro Footballer herself.  She said she called herself a 'Pro" because they didn't earn enough money for the "fessional" and that when her team won a championship following a 12-0 season, she got her first paycheck along with her championship ring. The check was for $12.  But she was paid to play her sport, football, and that was a big deal.

LaChina and Panel: Jen, Ginny, and Charmelle

Also on the panel was Seattle Storm co-owner Ginny Gilder (Twitter @ginnygilder) who I've previously written about here and who is an Olympian Rower.  What stuck out to me from Ginny's talk was how the Storm ownership group, Force 10 Hoops, initially came together to determine why they wanted to collectively purchase the Seattle Storm.  They wanted to support a team that the community loved, but they also wanted a platform to use to support the changes they saw necessary in the world.  After five years working with the team, I had never heard that story, and now I can't wait to hear more about it.

Third on the panel was Penn State Senior Associate Athletic Director Charmelle Green (Twitter  @charmelle44) who played college softball at Utah and was the only black female athlete on campus at that time.  She talked about her career path and about learning from your mistakes and using them for growth.  Carmelle is also the President-Elect of WeCoach who sponsored this event.  The Vision Statement of WeCoach is "recruitment, advancement, and retention of women coaches of all sports and levels."  Throughout today's event, data was presented showing that female coaches don't stick around as long as their male counterparts.  The data improves if the female coach was, herself, coached by a female coach.  The data also improves if females were asked as student athletes if they would consider coaching as a career after college - compared to those who were never asked to consider that path.  The data was presented in an online live Q+A chat during their lunch session by two of the later presenters.

It was at this point that I unfortunately had to head out for my appointment with my therapist because #mentalhealth.  In the car I listened to the presentation of Felecia Mulkey (Twitter @BaylorAcroCoach), Acrobatics and Tumbling Coach at Baylor University who discussed the process of developing a team culture using Dr. Bruce Tuckman's "Developmental Sequence of Team Development" model.  She uses boundaries, clearly defined expectations, and consequences paired alongside coaching staff congruency to make sure her team functions as a program.  I liked her discussion of how a coach can't really choose the culture of their team, the culture is what the team thinks it is and the coach can impact that culture with how they lead.  Then I had to miss some of the Summit, but it's going to be available in recorded form and I guarantee I'll catch up and watch WNBA All Star playing for the Connecticut Sun, Layshia Clarendon (Twitter @LayshiaC) because she's an awesome human being and I was bummed that I missed it today.

Betsy Butterick

Following mental health came physical health.  I made it to the gym in time to catch my old pal Betsy Butterick, The Coaches' Coach and Communication Specialist. (Twitter @BetsyButterick) with her presentation. What could be more motivating on the treadmill than watching Betsy demonstrating how easy it is to tangle up communications as she was instructed to make a PB&J sandwich.  Something so simple went horribly wrong in a memorable visual presentation.  I first met Betsy in 2007 when I worked for the Connecticut Sun and she worked for the Seattle Storm.  We were both doing laundry for our teams and there was a small group of us around the WNBA at that time who were around the same age, all hoping to find our paths in women's sports. She's paving the road for many behind her and elevating so many coaches with her work, doing amazing things.  We both participated in the Women's Basketball Summit which I wrote about here, and you can check out her latest work here!

I missed the next presentation and a half because I needed amped up music to deadlift, but then saw the second half of the data on women in coaching presented by Dr. Nicole Lavoi (Twitter @DrSportPsych).  Dr. Lavoi is the Director of the Tucker Center for Research on Girls & Women in Sport at the University of Minnesota, but what I did hear was a combination of optimistic room for growth and disbelief at the current status of the NCAA.  It made me sad to hear how few women hold higher up roles in NCAA Intercollegiate Athletics as well as coaching women's teams around the country.  Women in higher ranks will ultimately help women get the jobs in sports they aspire to have, so the future will hopefully have room for more female athletic directors. There are report cards grading athletic departments based on their gender hiring practices.  UConn doesn't look good with their D, but the shining light was seeing my college professor, Dr. Laura Burton, on the Tucker Center staff.  She was always pushing for improved gender opportunities 15 years ago.  I didn't know the Tucker Center existed, but I can't wait to read through some of their research in the upcoming weeks and finish watching her presentation.

LaChina and Holly Warlick

By now I had made it home for a late lunch... I'm sure you're wondering... chicken salad in corn tortillas, taco style. I was able to finish watching the last interview with former Tennessee Lady Vols Women's Basketball Head Coach Holly Warlick, who spoke highly of legendary Women's Basketball Coach Pat Summitt.  Holly's top quote was "You meet the same people on the way up that you do on the way back down, so treat people with respect."  She also gave the advice to young coaches that they really need to love what they're doing.  Coaching is a huge time commitment that requires you to sacrifice time away from your family, so loving it and having family support are essential.

Then I went to Target.

Overall, a pretty awesome day.  I really enjoyed the parts of the Summit I was able to watch and can't wait to fill in the gaps soon.  Hopefully they'll do a repeat next year.  What did you do ttoday?

Warm Up Like You Mean It

Photo Credit: Seattle Pediatric Sports Medicine
I'm front-right, and I need to work on my landing.

High school and college basketball season is here!!!!!! (YAY!) I'm so fortunate to have many friends who coach or work in high school and intercollegiate athletics.  This post is for all of you.  It's tinted towards basketball, but it could apply to any sport. 

Working in pediatric sports medicine, I notice clusters of injuries which coincide with the change in sports seasons.  This is, of course, a generalization, but it seems that there are patterns. Some examples: shoulder overuse injuries in swim and baseball season, concussions as football gets underway, "shin splints" in cross country runners who may have ramped up too quickly, and ankle sprains with soccer and basketball.

So now that the sports seasons are changing and I'm expecting to start seeing basketball players in the clinic, I thought it was time to hop on my soap box suggesting the use of a dynamic warm-up as an injury prevention tool. It has recently come to my attention that some of the local high schools are so overbooked on their gym time that the athletes are expected to warm-up on their own before they're allowed access to the court.  The team does not warm up together unless the captain organizes the group beforehand.  To me, that means it isn't mandatory.  It isn't a priority.  If teams only get 2 hours of on-court time per day, they'll use the time to focus on sport-specific activities, no time wasted on preparing their bodies.  I get it, but I don't approve.  I think you might end up with a team that knows a few extra plays, but you also might have a few more injured players on the bench.  Is it worth it?  There's quite a lot of research on the benefit of ACL injury prevention programs, including the 2018 National Athletic Trainer's Association Position Statement written by an awesome group including my mentor, Dr. Lindsay DiStefano, which can be found here.  (That paper includes the components you should include in your injury prevention program... no worries ... they're going to be briefly summarized below.)

I've previously mentioned that an injury prevention program is the same thing as a performance enhancement program here.  Most of these programs are targeting prevention of ACL injuries, but there is no reason to believe they couldn't help prevent other injuries, as well.  The Seattle Pediatric Sports Medicine Group's ACL Injury Prevention Program and the FIFA 11+ programs were both designed to be used as a dynamic warm-up.  Note that I'm using three different names for the same thing: Dynamic warm-up, if used properly, is the same thing as an injury prevention program, which is the same thing as performance enhancement.  (There are many other programs out there, but these are the two I'm most familiar with and have seen teams use most frequently. Ignore that they're set on a soccer field... it doesn't matter!). 

Let's back up for a moment.  What is a dynamic warm-up?  A dynamic warm-up is a progressive increase in the intensity of exercise placed at the beginning of a training session to prepare the body for the work it will do.  It targets increasing the cardiovascular system and getting the blood flowing as well as progressively increasing the use of the musculo-skeletal system and the nervous system to optimize the body for movement.  There are numerous publications that recommend doing this for a variety of reasons.  Like this article for injury prevention, and this one to optimize power. You've probably learned that you shouldn't skip meals leading up to Thanksgiving Dinner (though many people wrongly think this means more room for extra desserts, you're better off having some breakfast earlier in the day and regular eating the day before.  You're welcome.)  Why would you go from sitting in school all day long to sprinting up and down the basketball court without preparing your body?

Great, so now that we've determined that you're going to include a warm-up in your teams' practices and before games, why not decide how to design the warm-up for optimal performance?  This really can't be just about going through the motions.  It needs to be intentional.  It needs to be focused.  This is a great opportunity to develop a plan that team captains can lead early in the season so you can help teach individuals who might need more help with some of the movement patterns.

No more sitting in a circle stretching and chatting about last night's episode of Grey's Anatomy. Focused, purposeful movement.  There are SO MANY activities you can include if you're not able or willing to use one of the programs already designed for you due to the amount of time they may take.  I urge you to consider one of those programs, but alternatively, take the components from those programs and use them interchangeably.  If you structure your practices so you know what things you're going to work on, you can also structure your warm-ups so you know what you're going to work on in that time. What good is running a play for your shooter if they're not yet getting off the floor with their jumps?  What good is spending an hour teaching your team how to get a pass into the post if your center doesn't understand the benefit of getting low (in their squat pattern) to back down their defender and take it to the hole.  I'll say it one more time for the people in the back, injury prevention IS performance enhancement and a dynamic warm-up is an easy way to fit this into your daily routine.  If you help develop your athletes into just that - better athletes - they'll have more skills available to them to apply to whatever sport they're playing.

Components you should consider using in your warm-up.
1) mobility/flexibility (walking stretches)
2) strength (of the hips and core as well as the upper body) which can be done using:
3) movement patterns (squat, lunge)
4) jumping (plyometrics)
5) balance
6) agility (cutting/change of direction)
According to the NATA position statement, you should be using at least 3 of the above categories.  The prepared programs use all of them.

I don't have data to support this claim, but in general, I would say that most of the injured teenage girl athletes I see in the clinic do not jump or land in an "optimal fashion".  They're generally strong, but need to be stronger for the demands of the sport they're playing.  They often can't squat without falling over and I don't think I've seen any who can control a single leg squat.  As a coach, if you don't know how to teach these things to your players or why they're important, you could ask a local physical therapist to come in and screen your athletes and give you some pointers.  Or call me and we can chat about them!  Seriously... any time.  If this post prevents one high school basketball player from injury, I'll be happy.  Or if this post changes the way a coach organizes their practice to include more of the above components, I'll be elated.

As a reminder -
Every jump shot is, in fact, a jump and a landing.
Most rebounds are, in fact, a jump and a landing.
Jump-landings are, in fact, related to the squat.  If you do it on one leg, it's more related to a single-leg squat.
Defensive stance and the "triple threat" position are, in fact, related to the squat.
If you are standing on one leg for any reason - landing from a rebound, trying to save a ball from going out of bounds - you need to be able to balance.  Most teenagers can easily stand on one foot on a firm surface and balance steadily without a problem.  But if they have had an ankle sprain, it gets much more difficult.  If they're turning their head - like they would for an outlet pass or to avoid a defender - it gets much more difficult.

I'll go back to the discussion of getting the high school girls into the weight room another day, but for now, strength training could be as simple as a few sets of squats and a few lengths of the court with walking lunges and a few side planks - all with body weight - to focus on movement patterns and strengthening.  That could easily be a huge part of their warm-up before playing basketball.  (If you're preparing for a strength training workout, the dynamic warm-up should more closely mimic the motions of the exercises to be completed, but for a sports practice, there's a ton of variety available that will be relevant and beneficial). 

Last thought on these warm-ups.  Something that makes my mind go nutty is watching a team practice where they spend a good 15 minutes warming up, and then the coach has them circle up and stand still to discuss the upcoming practice, ultimately cooling them back down.  Prepare your team's mindset before the warm-up so you can transition right from the warm-up into business.  You can't avoid it during games when you substitute a player from the bench and they've been sitting for the whole first half.  That player is cold and has to use the game to warm up. Hopefully the energy of the game has kept the blood pumping a bit.  Hopefully they do some jumping up and down on the sidelines when your team makes a great play, to keep them warmer.  But on a daily practice routine, you can keep them warm and ready to go.

Any questions?  Let me know if I can help.
Here's to a great basketball season with zero injuries for your team.  And lots of offensive rebounds.  Those are my favorite.

(Go Cheshire Rams! Go UConn Huskies!)

Women in Sports in the News!

I have several blog posts that I have started drafting that are in skeleton form.  Ideas pop into my head while I'm doing my continuing education work or reading things online that I think I'll want to learn more about in the future and I start up a draft for later.  I had plans for this week's blog because I just finished reading a book I really enjoyed... and then I hopped onto my Twitter and Facebook accounts and saw two really awesome articles about some amazing women in sports.  Change of plans! This week we're looking at some real trailblazers.

First: this awesome video from Gatorade Performance Partners about the Female Athletic Trainers serving in the NFL. Maybe someday, it won't matter that we identify them as females... but for now, this is important!  I came upon this post because the Head Team Physician and Orthopedic Surgeon for the Connecticut Sun, Dr. Katherine Coyner, tweeted it.  I recently connected with her and have been following her work at the University of Connecticut Health Center and with the Connecticut Sun from afar.  (To my knowledge, there are four WNBA teams that have head physicians who are women, two of which are orthopedic surgeons.  The Minnesota Lynx operate with surgeon Dr. Nancy Cummings, the New York Liberty work with Dr. Lisa Callahan, and the Phoenix Mercury work with Dr. Amy Jo Overlin.  These women are trailblazers and their career paths are inspiring!)  Back to the video... there are six female athletic trainers in the NFL out of 145.  But more than 50% of athletic trainers are females and more than half of the current students in athletic training programs are also females (according to the clip).  I'm sure these ATCs don't all want to work in the NFL - or potentially any of the professional men's sports... but opportunities for women in professional sports are limited.   Check it out!


I saw this video first thing this morning while I was perusing my social media over breakfast.  I then went to work... treated some kiddos at Seattle Children's Hospital... and came home to find this post:

<--Jenny Boucek, former Seattle Storm Head Coach, now Assistant to the Coaching Staff/Special Projects with the Dallas Mavericks

I first met Coach Jenny Boucek when I was an undergraduate at UConn and she came to watch practice before an upcoming WNBA draft.  I remember asking her if she wanted to draft a team manager... I already knew where I wanted to go after college.  We had a nice chat and our paths crossed numerous times over the years.  I loved that she was the Head Coach when I first came to Seattle to serve as the Storm Physical Therapist.  She's a wonderful person.  And now she's navigating uncharted waters as a pregnant coaching staff member for an NBA Team!  I can't wait to hear more about how her story unfolds, but this first article about her job prospects from a few NBA teams gives me hope. I truly believe that with ANY job... it should only matter that the best candidate is hired.  Based on this, it looks like employers are now starting to join in that belief and cross the gender boundaries that were so much more rigid in the past. Way to go, Mark Cuban.

Both of these news clips brought me joy.  The opportunities for women are growing right in front of my eyes, particularly in sports - and not just in women's sports.  We can still do better - but let's enjoy these moments and then get to work on making more progress.  This upcoming weekend is the WNBA All Star Game and I can't wait to watch while I'm on a quick visit home to the East Coast! 

Any other inspiring stories you've come across and want to share!?  Post a comment... and consider following the blog!

Shoulder Care with Eric Cressey

Last weekend I jetted off to Denver for a visit with family and a continuing education course.  The family time was fantastic - a few hours of biking around Denver - far more than I'm used to doing as I'm not a fan of bike seats - some really delicious tacos - beautiful art and the backdrop of the Rocky Mountains!

The course was "Shoulder Assessment, Corrective Exercise, and Programming" presented by Eric Cressey of Cressey Sports Performance and it was hosted at Landow Performance in Centennial CO.  Loren Landow is the newly hired Strength and Conditioning Coach for the Denver Broncos and his facility is beautiful with state-of-the-art equipment and autographed jerseys all over the walls from numerous professional athletes.  His bio says he has trained WNBA athletes, too - so extra points in my book!  If you're not familiar with Eric's work, he's a Strength and Conditioning coach with facilities in Hudson, MA and Jupiter, FL and, though he is most well known for his work with professional baseball players, he also works with the general population and is considered to be an expert in the shoulder.  He's published tons of research and has a blog with articles posted starting in 2002 with regular high quality content.  I previously wrote about one of his older blog posts here.  Most importantly, Eric is a UConn grad, so I've followed his work since I first learned about him somewhere around 2005 when I was in a class with Dr. William Kraemer, one of Eric's mentors, and have been looking forward to meeting him and attending one of his seminars for a long time.

With Eric Cressey June 24, 2018

Why did I want to take this class?  Beyond wanting to hear Eric speak live and get the chance to ask him questions, I previously took a course with a strength and conditioning coach (Matthew Ibrahim) in conjunction with a physical therapist (Zak Gabor) which I wrote about here, and felt that learning from people with different backgrounds was really impactful for me.  The audience was primarily strength and conditioning coaches who work with baseball players... but there were also a handful of physical therapists, chiropractors, massage therapists, personal trainers, and baseball coaches.  People had traveled from Australia and Korea and all over the United States, some of which trained athletes from unique sports like Professional Disc Golf or MMA fighters. The variety of people present was really neat... but also, the content is applicable to so many other sports.

More importantly, I have been treating a lot of patients and athletes with shoulder injuries and recently completed Mike Reinold's shoulder seminar, but also wanted a live course to better observe how other providers evaluate and treat shoulder pathologies. Eric's approach to shoulder treatment does not look like Mike's.  They have different "favorite" screening tools and exercises that they use.  If you observe their social media, you could probably pick up on these differences and similarities.  I'd say the biggest overlap I observed was that both of them regularly use the prone low trap exercise for rotator cuff strengthening which Eric has a video for here.

When it comes to my work with the Seattle Storm, though, we also have to consider that we're working in an overhead sport with repetitive action.  Shooting a basketball is nothing like the motion of throwing a baseball, but it still requires significant mobility and stability - and very different from baseball, it requires the athlete to be reactive to opponent players slapping at their arms while they're doing it.  The arm care programs used by the Seattle Storm should not look like the arm care programs used by the Boston Red Sox - but the principles involved in developing them do match.

I learned a lot from this course which I'm still processing, but was able to immediately use some of the skills in the clinic. Here are my top 5 favorite Eric Cressey quotes and take-aways from the weekend.

1) The biggest key for the shoulder is "Keep the ball on the socket." Simple.  Having a better biomechanical understanding of the force vectors of the rotator cuff is vital. If the scapula is sitting in a depressed position, the lats may be over-active which will influence upward rotation when getting overhead.  Similarly, if the scapula is tilted anteriorly, could there be shoulder impingement with elevation or is there enough muscular balance to safely overhead press?

2) Rehab and training are the same thing!  I've previously written about physical therapists' role as strength coaches here - and this came up in the course.  Eric Cressey is not a physical therapist and he discloses this and discusses how he interacts with PTs all over the country.  So it surprised me to see the differences between what Mike Reinold and what Eric Cressey do considering this statement, but I would not expect Eric to be seeing athletes post-op day 1 following labrum repair.  So, I took this to mean that once the acute healing phase is completed, rehab and training are the same thing.  There is a need for progressive loading to tissues and a need to understand periodization, even if your PT treatment sessions are not written like a periodized training program.

3) Scapular winging is a garbage term. It does not describe what is going on with the scapula.  I document scapular winging all the time - so this will be a change I need to consider moving forward.  Is the scapula winging because it is anteriorly tilted?  Upwardly rotated?  Because there is a flat thoracic spine so the medial border is just more pronounced?  And is this inherently pathological?  Or just a finding that you're documenting.  I can't promise I'll stop using the term scapular winging entirely, but I can commit to adding at least one descriptor of the scapular position to better describe the situation moving forward.

4) Stop telling people to bring their shoulder blades down and back.  It would only be a slight exaggeration to say that Eric Cressey is begging people to stop using this cue.  Too many people use this resulting in patients pulling their elbows back with anterior humeral head translation and improper mechanics that we could be creating problems!  I asked him what cue he likes instead - and he said he manually puts people into the position he wants them to be in, using optimal muscle activation, until they can do it independently.

5) Push:Pull ratios are not accurate nor are they adequate.  It has been well ingrained into my training that for every push exercise, you should be doing at least 2, probably more like 3 pull exercises.  I've been trained to teach that focusing on the back musculature 2-3x more than the front helps combat many of the anterior shoulder issues that are seen in the clinic.  However, Eric points out two key points that make you think about this more carefully.  First, the push:pull ratio is almost always considered for front:back motion and ignores top:bottom... but both planes need to be considered.  I think John Rusin tries to deal with this by including upper body push, upper body pull, and carries into his 6 foundational movement patterns, but the balance needs to be considered for both planes.  Second: not all pushes can be considered alike.  The bench press is a push exercise that necessitates the scapulae being blocked on a bench... compared to the push up where they are moving freely on the body.  This is also an important consideration as you're not getting the benefit for scapular control through the pushing motion when doing a bench press - and Eric says he doesn't have his baseball players bench pressing.

I'd be lying if I said this even touched the surface of all the things I learned at the class... but these were big takeaways that made me think and will change how I operate to some degree.   Thanks for an awesome course, Eric!

Book Alert: Conscious Coaching - by Brett Bartholomew

Quoting a quoted passage- “People won’t care how much you know until they know how much you care.”

I just recently finished reading Conscious Coaching by Brett Bartholomew.

What I really enjoyed about this book is that Brett welcomes you into his personal life to the deepest level.  He had some really challenging obstacles to overcome in his youth which he goes into great detail explaining and makes you want to reach into the book and give him a hug.  I've seen some of his posted videos on social media and he has an engaging personality and a voice worthy of being a radio talk-show host, so it was eye opening to hear of his past and where he has come from.  It also becomes alarmingly apparent that his health issues were severely mismanaged in the healthcare system at the time.  This is tragic and, as a healthcare provider, it made me think about my current patient caseload wondering if I'm doing a good enough job listening to my patients, hearing their concerns, and doing what's best for them... not what I think is best.

One way that I try to remedy this concern is that I ask EVERY new patient the following three questions:

1) What do you think is going on with yourself?  Particularly working at Seattle Children's Hospital where my patients are young kids and often have never had pain or physical therapy before, this is important.  Most commonly - I get very simple answers.  "I sprained my ankle."  "My knee hurts."  Once in a while they have seen another PT or a chiropractor and already have a mindset of "My pelvis is out of alignment."  Asking a patient what they think is going on helps you understand their mindset and helps me determine any beliefs that I may have to address, and leads perfectly into the next two questions.

2) What do you think will help you get better quickest?  If a patient thinks that manual therapy will help them, and I only guide them through an exercise program, the buy-in from that patient is less because I haven't listened to their desires.  This occurs much more often with the older population who has had physical therapy before and has seen what worked in the past.  The younger population generally shrugs at me with a blank look on their face - and I explain how physical therapy works and usually my typical treatment patterns: Range of motion restored first, then strength and stability - along with the concept of progressive overload - which I've previously discussed here. 

3) Have you ever had physical therapy before? This question really should be mandatory for every patient evaluation.  Always.  It gives you the opportunity to explain what you're going to do in your evaluation and in subsequent sessions for those who have never been through PT before.  It gives you a chance to calm any nervous patients - because many of them are anxious and with the children I work with - they've often never had pain before and don't understand that they're about to be touched.  It should go without saying that you have to have permission to touch your patients - so here's an easy way to get that approval.

Back to the book. The global purpose of the book is to help coaches better interact with their clients - to build buy-in.  It comes from a Strength Coach perspective, but can be applied to people interacting with others. Brett breaks the book into three major sections.  The first is a series of ways to identify yourself with 3 stages of Internal Identification: Reflection, Inspection, and Progression.  Included are a series of options for self- testing to determine your personality type including the Myers Briggs, which I had done in PT School and identified me as an ENFJ (Extrovert-Intuition-Feeling-Judging): The Compassionate Facilitator (also considered the protagonist or leader of the pack depending on source).  These pictograms describe my type and appear to be spot-on.  This test, and the others that Brett describes in the book, are meant to help you understand yourself before interacting with others.  Though they all have a fee - I always find it interesting to learn about my own personality qualities and there are tons of abridged versions online that can be taken for free to give you a taste of your own personality.  Along those lines - Brett advises that you "resist the urge to collect resources or data points just for the sake of having them."  I didn't complete all the tests listed to have several personality tests describing me... just the one was sufficient.


This section also examines types of conflict.  "Conflict often leads to conversations that become catalysts for growth by opening up the opportunity for different perspectives and views to be voiced... Conflict keeps us honest."  There can be conflict about a task, when there is disagreement about a task and how to manage it.  There are personal conflicts between people with a need to seek resolution.  And there are different strategies to manage the conflicts that arise.

The next section describes different "Archetypes" or typical descriptions of types of people to help better understand your clients.  Each Archetype is defined with their usual strength and weaknesses, suggested ways of how to optimally interact with that personality type, and then an actual case study describing an interaction with someone of that type.  Every patient or client is different and sometimes it can be very challenging to create an alliance with all those differences.  Reading the book made me consider the complexities of an introvert doing my job on a daily basis - and conversely on how I would feel working in a career that is primarily working alone or that does not regularly interact with others.  I love people and I love talking... those would be challenging!  It also made me wonder which Archetype I would fit into, and if any of my previous coaches or mentors have categorized me and used any of these principles.

The last portion of the book is application and ways to develop trust.  Brett presents 13 Coaching Mistakes to Avoid.  I've faced many of these situations along my career, fortunately avoiding many of them, but the way he presents the concept of "taking things too personally" made me laugh.  He explains "Nobody else wakes up worrying about Brett... refuse to let an action become your identity - you need to understand that experiencing a moment when you have fallen flat on your face or embarrassed yourself does not mean that you are destined to be a lifelong failure."

If you coach athletes - this is a great read.  And if you interact with others on a regular basis, or want to have a better understanding of your own personality and behaviors - you can pick and choose the pieces that apply to you.  Check it out!

Geno Wins 1000!

This post has nothing to do with Physical Therapy.  You have been warned. 

https://stocksnap.io/photo/0QJJYBAVZ1

This is A goat.

This guy - the guy in the middle of the huddle - is THE GOAT.  Greatest. Of. All. Time.

That's Geno Auriemma - the Women's Basketball Coach at the University of Connecticut.  And today, he won his 1000th game. I've been to a lot of UConn Women's Basketball games and seen a lot of those wins.  Working with that team was a HUGE influence on my path to where I am today.  My parents were there to celebrate my dad's birthday tonight - because my family bleeds UConn blue (except my brother who got lost and went to the University of Vermont - but would probably still cheer for UConn under most circumstances).  Congratulations to Coach Auriemma and to Associate Head Coach Chris Dailey - who has won those 1000 games right alongside him.  Thank you for all the excitement!

Go Huskies!