My physical therapy clients clients range from two years-old to 94 years-old. My personal training clients have ranged from ten to 80 years-old. My training clients have typically fallen in three psychographics.
The first group is young athletes. The start of my private practice was filled with figure skaters and synchronized skaters I trained and treated. Football players, baseball players, lacrosse players, runners, and triathletes made up the rest of the athletes. Training these clients is based on three, six, and twelve month cycles getting ready for the next competition or next season.
The second group are busy professionals age 40 to 55 who own their own business and vigorously attack their fitness and athletic hobbies. Training and treating them is a mix of building and rebuilding with the training focus shifting every month from skiing to biking to running.
The third group are clients age 55 to 65 with a parent who lived to be in their late nineties. They have 30 to 40 years ahead of them and want to be in better physical and mental condition than their parents. We work on undoing most everything they have done or not done since high school. Restoring and building joint mobility, strength, flexibility, balance, endurance are the main goals. These clients take the physical qualities they develop and pick up new sports including downhill skiing, kayaking, standup paddleboard. The training plan is based on maximizing function and athleticism while minimizing decline over the next three to four decades.
Working with a twenty to thirty year plan means I am always considering alternatives and consequences with exercises. Will this nick up their knee or shoulder? What are the benefits of squats over step downs? What step height will be challenging but not aggravate the osteoarthritis in their ankle or knee? How do we build chest or back strength while working around the old rotator cuff tear? It is less “Can we run up this staircase in under 5 seconds?” It is more, “Lets make sure I still go up and down stairs in fifteen years.”
What should your physical health and fitness be in thirty years? Do you have a five year, ten year, or thirty year plan?
I received the first dose of the Pfizer vaccine Monday. St. Louis County Health was a timely, smooth, efficient machine. I was in and out in 25 minutes. Five minutes or so were spent getting the paperwork squared away and waiting to head back the the treatment room. Three minutes to fill out the vaccine card and receive the shot. And fifteen minutes waiting to make certain there were no adverse effects.
As a healthcare workout I was in one of the top tiers. I know people are jumping the line while other people are hesitant to receive it. My suggestion is to get on every list for an appointment you can find. It would be great if there was a centralized clearinghouse but there isn’t. Register at every hospital. Ask friends if they know a place. If you can travel for the vaccine, take a road trip. Friends have driven three hours each way to obtain it. Vaccine availability will increase. Your phone will buzz with a text or an email will hit the inbox. Hang in there and keep signing up.
In three weeks I will have the second dose and have a little more piece of mind.
I had a mild headache and went to bed early. My arm is mildly sore. It was been recommended to me too late to hydrate heavily before the vaccine. I did not drink enough.
I hope you get vaccinated soon and we get back to a better way of life this summer.
This summer my daughter had an internship removing invasive plants at Delaware’s State Parks. She needed portable exercise equipment and I had a few pieces she could borrow.
She grabbed a kettlebell and I loaned her a portable DVD player and two kettlebell flipping videos from Jeff Martone. Jeff was part of Pavel’s original kettlebell efforts (RKC) before he was excommunicated.
She quickly mastered the basics before progressing to releases, flips, and some juggling moves. She was nice enough to send some videos home of her progression.
As she learned to juggle the kettlebell she found what she was not lookinfg for: a moment of zen.
Your mind can wander when you are doing a set of 20 or 50 swings or snatches. It does not wander when you release a kettlebell. The world disappears and goes quiet as you focus on the revolving bell and look for the handle to come around. That silence is golden.
When you have mastered the kettlebell swing, try learning a release and then progress to a flip. Working a release or flip into a circuit or set of 20 every 5 or 10 swings is a tremendous focusing event. There are plenty of videos on YouTube so I will leave my instruction at that.
Try something new and give kettlebell juggling a try. I hope you experience the same moments of focus and quiet and zen that my daughter and I do.
Years ago I had a client with foot pain. She had struggled through the whole track season. She was a pole vaulter and would take two vaults to win the meet. And that includes her warm up vault.
The State meet was ten days away. She had been using modalities all season without relief. I met with her and the time frame limited my options. What I did have to offer was aggressive rest. I put her on crutches. She used crutches every day the entire time and even used them walking onto the track at he State meet.
She managed to do 10 vaults and medaled at State. Healthy, she should have won State but a medal is better than nothing.
So if you are miserable, hurting, and have an event in a few days you absolutely must do, try aggressive rest. Unload the affected tissue as much as possible. Will there be atrophy? Yes. But there is going to be atrophy with pain and inflammation anyways. Eliminate as much pain, spasm, and inflammation as possible and make an attempt with your event.
Good luck.
My daughter just completed a five week winter internship. A Grinnell College alum hired four students. You can read the owners story of the internship here.
My daughter learned about the creator economy, personalizing emails and pitches, and tailoring a marketing message. During Saturday morning meetings, Hallie learned about business structure, negotiation skills, resumes, and a number of things she didn’t want to hear from me. I would love to help her learn business skills, marketing, finance, tax planning, business structure. I can nudge and coax but it has limits.
A number of things struck me about her internship. First, she developed business and life skills and literacy she was not going to learn at a liberal arts school. She was learning from a recent graduate of a liberal arts school who knows the gaps and deficits of his education.
Second, she was paid a decent wage. She made as much as I would make all summer in high school during her winter break.
Third, the alum was shipping product. He graduated in May of 2020. He wrote a book and sold 500 plus digital copies before progressing to a physical copy. He did not take three years talking about doing it. He wrote a book and put it out there. He hired people to ramp up his sales. And he is not even 12 months out of school
I am impressed. I hoped she took notes.
Opt in is when you have to sign up to receive something. Opt out is when I am going to send you my email until you complain.
A major insurance company moved their payments from check to electronic ACH payments. The explanation of benefits (EOB in medical language) which explains what was paid for, how much was paid, and what wasn’t went online through their portal.
After ten months, I received an email informing me that I had upgraded to the premium version of their payment portal. The free trial would expire February 28th and then it would cost 0.5% of claims paid. I never signed up for the premium portal. I haven’t been on their portal since we set it up. They were acting like I opted in when I need to opt out.
Remember in Superman 3 when Richard Pryor’s character sets up a program so all the fractions of a penny in the company payroll software flow to him. Of course he spent it on fancy cars and was immediately caught.
This is even craftier. What is 0.5% of a trillion dollars of claims paid? 5 Billion Dollars! If only 1% or providers don’t opt out of the premium portal, the company will pull in as much as 50 million. Fifty million dollars paid by providers to the insurance company for electronic payments and online EOBs which save the insurance company money in the first place.
My dad would have said “They have the guts of a bankrobber.” To make it even funnier, they technically are a bank.
I was finishing up treatment notes last night and trying to fix a few things on a website. I set up an office in the basement to get away from the television and focus on the task at hand. It sits outside the workout room.
My wife came down to workout and was done warming up.
“Turn off the computer and workout,” she said.
“After I fix these two things,” I replied.
“Now,” she said 3 minutes later.
I flipped the laptop shut and got the workout done.
Thanks to my mean wife I got a workout in that I might have skipped. One more step getting back on track.
Thanks Tami.
When I was a physical therapist at St. Louis Children’s Hospital I worked with patients of Dr. Perry Schoenecker. Dr. Schoenecker recognized some parents were having difficulty bringing their children to office appointments. He responded with a midnight clinic. Kids would be in the waiting room sleeping in their pajamas until they were called back. Entire families would be there together. Legend has it that the no-show rate for the midnight clinic was close to zero.
I am certain that the midnight clinic was rough on the lives on staff. I am certain there were grumbles and push back from staff. But it met the needs of the customer.
I see some established clients on Sundays because they cannot get their schedules to match mine during the week. When I started my practice I worked late two nights a week. I missed out on being Vice President of the Eastern District of the Missouri Physical Therapy Association because of this. Meetings were once a month on Tuesday night. I was starting TheraPlus and chose my business instead. As we had more children and my life changed I modified my schedule to be more family friendly. My wife wants me to drop Sundays but I have clients who need that time.
I am scheduled to get my Covid-19 vaccination next week. Appointment times were between 9 and 4. I understand that vaccine supply is limited but why are vaccinations not being administered over two or three shifts instead of one. Hopefully as vaccine supply improves, appointment times will be available to match people’s schedules.
Take a hard, critical look at your business and try to identify gaps and unmet customer need. Filling those gaps might be what your business needs to grow and succeed.
Listening to a podcast a few years ago a gym franchise owner was talking about training world class athletes. When asked to visualize a All Pro NFL offensive lineman you have an image in your mind. A picture of an All Pro NFL receiver might also pop easily into your head . When asked to visualize a Olympic men’s gymnast you easily do so. When asked to visualize a pro soccer player you have a picture in your head.
What does a world class seventy year-old man look like?
I visualize him as having 10 to 15 percent body fat with significant muscle tone. He has a thirty inch waist and wears a size large shirt. He exercises daily in a variety of activities. He lifts two to three days a week. He runs and swims two days a week. He does yoga, Pilates, or Tai Chi once or twice a week. Somehow he even has a full head of hair.
I have a 74 year old client I have seen periodically over the past six years. When I last saw him, he shared his goal of setting the age-group record at the Go St. Louis Marathon. It was then that it hit me. He is a world class seventy year-old.
How do you visualize a world class seventy, eighty, and ninety year-old and what are you doing to become one?
Tom
Dan John introduced me to the concept of park bench and bus bench workouts.
Bus bench workouts are the difficult workouts seeking immediate results. You are there for a purpose, like sitting on a bus bench waiting for the bus to get you to your destination.
Park bench workouts are when you are there to enjoy the process, enjoy the view, and relax.
Bus bench workouts are difficult for me to execute during the pandemic. There is nothing scheduled to train for at this moment.
My park bench workouts are the foundation of my social life. I workout with whichever friends are available. There is minor league competition with someone trying to win a movement. There is griping, problem solving, and smack talking. This is how I unwind.
I’ll receive my first dose of the Pfizer vaccine Monday. Then I will be one step closer to getting back to my workouts and my social life. I hope we all get there soon.
Tom
