The Show Up Fitness Podcast
Join Chris Hitchko, author of 'How to Become A Successful Personal Trainer' VOL 2 and CEO of Show Up Fitness as he guides personal trainers towards success.
90% of personal trainers quit within 12-months in the USA, 18-months in the UK, Show Up Fitness is helping change those statistics. The Show Up Fitness CPT is one of the fastest growing PT certifications in the world with partnerships with over 500-gyms including Life Time Fitness, Equinox, Genesis, EoS, and numerous other elite partnerships.
This podcast focuses on refining trade, business, and people skills to help trainers excel in the fitness industry. Discover effective client programming, revenue generation, medical professional networking, and elite assessment strategies.
Learn how to become a successful Show Up Fitness CPT at www.showupfitness.com. Send your questions to Chris on Instagram @showupfitness or via email at info@showupfitness.com."
The Show Up Fitness Podcast
Cash Vs. Insurance PT Explained w/ Dr. Kurt Kessler
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What if getting “cleared” isn’t even close to ready? We sit down with sports physical therapist Dr. Kessler to break down the real differences between insurance-based clinics and cash-based care—and why that gap can decide whether you return to sport strong or stuck at 70 percent. Instead of chasing codes and cramming notes, we dig into longer one-on-one sessions, meaningful assessments, and exercise dosing that actually moves the needle.
Dr. Kessler takes us behind the curtain of residency training, board exams, and the daily reality of high-volume clinics where documentation dictates decisions. We compare insurance goals—basic independence and ADLs—to athletic goals like sprinting, cutting, and lifting heavy. You’ll hear how test item clusters beat one-off special tests, why movement is medicine only when dosed right, and how to build capacity by targeting the real “why” behind pain. Hip pain in front? We talk posterior capsule, loading strategy, and the difference between protocols and problem-solving.
We also get practical about collaboration. Trainers who speak anatomy and program progressive overload can carry clients from pain-free to peak performance, while PTs who respect performance training build stronger, safer handoffs. Together, that ecosystem prevents re-injury and measures what matters: side-to-side strength, rate of force development, and readiness to play. We close with honest talk on sales, marketing, and education gaps that hold both fields back—and the simple fixes that raise the bar for everyone.
If you’re serious about better outcomes, stronger returns to sport, and a smarter PT–trainer alliance, this conversation will give you the playbook. Subscribe, share with a coach or clinician you trust, and leave a review to help more people find the show.
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Welcome to the Show Up Fitness Podcast. Great personal trainers are made. We are changing the fitness industry one qualified trainer at a time with our in-person and online personal training certification. If you want to become an elite personal trainer, head on over to showufffitness.com. Also make sure to check out my book, How to Become a Successful Personal Trainer. Don't forget to subscribe, rate, and review. Have a great day and keep showing up. Howdy, y'all. Welcome back to the Show Up Fitness Podcast. Last podcast of the year, we have special guest, Dr. Kessler out of PA. And he is a referral from Peugeon, who's been a great trainer. And we just love these connections where you're linking up with qualified medical professionals like Doc. And just wanted to say thank you for taking the time today, sir.
SPEAKER_00:Well, thanks for having me on. I'm excited.
SPEAKER_01:So we were chatting a little bit before this about the difference between cash-based therapy and insurance-based therapy. And I think it would be great to hear from the horse's mouth what that the difference is. And so when trainers are looking to network with therapists, just being able to talk the lingo is so important and knowing the difference between the two.
SPEAKER_00:I'll let you uh determine if it's the horse's mouth or the horse's rear end. So difference between cash-based and insurance-based. Um, so I started out in 2022, fresh out of PT school in typical insurance-based clinics. I worked there as a tech in high school. Um, and that that I mean, that's the only experience I ever knew until I got out there. And um, once I got into the field, I started, I did a sports residency, which is a one-year program, requires about five hours of continue education each week, five hours of on-field coverage of sporting events, and just a whole lot of in-person testing. It's a pretty intense year. Uh, and then at the end you sit for uh a board exam, a five-hour test. And so I have been working as a sports physical therapist for the last two years, uh, three years, sorry. Um, and what I found is that in the insurance clinic world, um, you know, that it's a business, first and foremost. And with uh decreasing reimbursement rates from insurance companies, that has really changed the landscape of the insurance-based clinic. And I'm just speaking from my own experience. I know there are a bajillion good PTs working in those settings. This is not an anti-insurance-based um rant here, uh, but just from my own experience, it was really hard for me to use all the education that I had gained through the sports residency. It was really hard for me to have three or four people in front of me at the same time and only be able to give a little bit of myself to each one. Um, and so at the end of the day, I just felt like I was leaving a lot of meat on the bone. I felt like really frustrated because someone would walk out the door and I would think, man, if I just had like 10 more minutes with you, I can make so much more of a difference. And that got to the point where it just, it just really ate at me. It wasn't, it wasn't an issue with my company. It's not like changing clinics or changing companies would have remedied what I was feeling. I was just very anxious every day going to work uh and having to see 12, 15, whatever. And I know there are clinics out there that see 20 plus a day. Um, I was only seeing about 60 patients a week, but even that, I just it was just really eating me up. So um I left that um and started my own cash-based clinic. Um, so don't deal with insurance companies and uh how that benefits the patient and benefits me. One, I get a little bit more control over my schedule. Um, I get a little bit better wages for my time. Uh, but more importantly, the person in front of me gets my best effort. And I can look them in the eye and say, I'm doing everything for you. And that wasn't always the case where I was before. So um I think speaking for myself, the quality of care is so much better. I get to consider not just the injury or not just um, you know, what whatever they're coming in for, but I get to like really piece together the puzzle throughout the entire body to make a lasting difference. And you know, the the biggest frustration was all the documentation, but you have a person in front of you who really needs something, and the insurance companies dictate so much of that care. What nobody wants to admit it, but they do. And so then you end up with someone who really needs a couple more visits, and insurance says, now you're you're done. We're not paying for anymore. And so when I talk to people now, I kind of tell them like it's perfectly fine if you want to use your insurance to go to PT. That's that's why we pay for it, that's what it's for. But like if you end up either not getting the results you want there, or um, another thing that we'll probably get into is you know, insurance companies only care that you can do your activities of daily living, they only care that you can care for yourself and be independent. Um, and I say that I'm sure other PTs would give me pushback on that, but I say that because as soon as you mention the word sports or exercise or whatever in your notes, like that's like a red flag to get cut off from insurance. So we need to, we would have to word things creatively so that insurance would continue to pay for it. So I was just I I get sick of playing that game, and now I just get to treat the person for whatever exactly they need, for how long they need whatever it is. And typically what I've found is people who come to me from the insurance clinics, like they can be out of pain, but they might only have, you know, 50 to 70 percent of their six rep max on their affected side versus their unaffected side. So like we're throwing kids back out there on the field at like 50 to 70 percent strength, and we wonder why they re-injure, or we wonder why then the next body part goes. And so a big focus of my business is getting people back to that true 100% where we can measure strength, where we can measure rate of force development, where we can measure all these different things, endurance, and make sure that they're ready to go and build them back up in a systematic way, much in the way that you work with people.
SPEAKER_01:I love that. And you know, not to switch it on to me, but I got into what I wanted to do to become a personal trainer. I want to become a therapist, but I wasn't smart enough with physics, but I was always injured. And so, like if I had you as my therapist, where I went to that PT mill where I would go in, I get my heat and then I get my ultrasound, I get a little five-minute massage, and I was always re-injuring myself. But if I went to a coach who and a trainer, sorry, therapist who knew what they were doing, my outlook would have been completely different. I would be in the NFL right now. And uh, but just to kind of put it into perspective, and let me know if if you agree with this, Doc, that so for trainers that are trying to understand what he's comparing how I will compare this to trainers, imagine working at a gym where they're paying you 20% of the session. So you're getting uh not much at all, and you are given a client, but you only get to train them for 10 minutes, and on top of that, now you have to go and write out the programming. And if you put in there, like, oh, I wanted to do a bench press at 85%, but that red flag comes off, you can't put that in there. So you have to kind of play by the rules and you have to you know appease big brother, and it's like you're saying, like, you can only imagine you have someone who wants to feel better, and I'm talking about like in the fitness side of it, but you only have 10 minutes and you have to spend so much time documenting stuff, it's just probably a huge burden on your back.
SPEAKER_00:That's that's a really good analogy. Um, yeah, for me, it's like my my business coach phrased it really well. He's like, you want to do the fun stuff, you want to like exercise with your patients, you want to do this, and then the first couple of times you do that as a PT, not as a tech, but as a PT, you're basically making the choice like, do I get my notes done and go home on time, or do I have the fun and then stay for three hours after? And then after a couple of times, you realize it's get my notes done and go home on time. So I also felt like I really lost some of that like really close personal connection. I I still had that connection with my patients in that setting. And I think I was pretty well liked, but um it just it just I just knew I could do more. I knew I could do better.
SPEAKER_01:Well, one of the things we talk a lot about is networking with therapists, and hence why we're having this conversation is from Peugeon. But in that respect, I feel like it would be pretty challenging if I were to go to that clinic where you're at it as an insurance base and and I try to you know connect with you. How would I, because essentially you would be a perfect person who I'd want to connect with, but I wouldn't have the time within that session. And so would it be like a reach out via email or you know, coming into the clinic one day and saying, you know, I'm a trainer in the area and I have a lot of clients who are looking for a great therapist and I'm looking to network with someone. What would that exchange or what would that optimization look like to you know potentially work alongside with you?
SPEAKER_00:The insurance-based setting, I think. Well, I'll say it, I'll say it this way: you you flatter me a little bit because of the emphasis you put on the doctorate degree and the respect that you give PTs as a profession, I really appreciate that. But I also kind of view what you do, especially as a qualified personal trainer, as um equally, equally respect deserving in your lane. Because um, especially in that setting, if if I was a really good therapist in the insurance-based setting, like I would absolutely a thousand percent need to find a good, qualified personal trainer to be referring people to, because I would know that the insurance-based setting is not designed to get athletes and active individuals back to 100%. So I would really need to rely on other people to help do that for me. I my job would be to get them out of pain, build them a baseline of strength back, but then to really reach their athletic or fitness goals, like that's where you come into play. So that would be super important. Now, my current role in the cash base, I really like these partnerships. I I've loved getting to know Pujan. And um I think the the relationship is equally as important um because there are things that he does or things that you do that are not my focus. So while I'm still getting people back to 100%, I'm really programming the exercise from an injury perspective, building tissue capacity for whatever tissue is injured. Uh again, looking at different body parts and including that. But the way that you guys program and the way that you uh the results that you get for I would say full body as opposed to just like uh a specific injury, I mean, that's like that's the best of both worlds. So um, yeah.
SPEAKER_01:I I love that. And and just a little thought experiment because I actually find it pretty easy to network with cash base because I tell trainers don't be frugal. Schedule appointment, pay them their hourly rate, and it's not like I'm showing off. I'm not gonna be like, hey doc, what are the rotator cup muscles? But just by going, because I'm always jacked up. And if we if you move weight, you're gonna have a little ankle thing come up. And so it's just fun to learn more. And so when you're going through the assessment that you're doing, which is phenomenal, you can drop little things, like you know, I don't know if it's like in my T5 or T6, something back there, but just by saying that, you'd be like, Oh, patients normally don't talk like that. What do you do? And then and it's a conversation, and oh you played sports, and then I love docs who have a background in you know orthopedics or sports or something because then I can just talk sports and it's just fun to do that. So then it's like you're you're building a relationship with that individual, that's the networking side, and then send them a family member or a friend. So then they're getting business, and they say, Okay, well, this trainer isn't coming to me with their handout saying, Give me your patience, you know, it's a it's a working relationship, but it sounds like from them the insurance side, it might be a little challenging just because of everything that's on your plate. But the pros and cons there is would you wouldn't be fair to say it, but most therapists probably start out at insurance based. Would you say that's pretty accurate?
SPEAKER_00:Yeah, yeah, probably 99 plus percent.
SPEAKER_01:So if you find someone, you can look at their profile, someone's a little younger. Well, then you you can find that entrepreneurial spirit. And it's like, hey, you know, doctor, I got a couple of people you can see at my gym, or these conversations then can progress into it's just it's like a doctor and a nurse practitioner, they're on the same team, but they have different roles. But I wanted to ask you about some of the transitioning that we're seeing more in the industry. I'm I'm seeing a lot more therapists get more involved on that strength side. So they're getting their CSCS and and they're now treating the patient, get him out of pain. And then it's like, you don't need to go anywhere else. I can just I can train you now, essentially. So we have a doc out of our place here, and that's what he does. And so he's from uh University of Spoiled Children, USC. And uh, so he rents space out of here, but then he trains them. And so that actual relationship isn't as optimal from the business side because I would like to say, Hey, you know, once you're done with those, send them to me. And then maybe we have like a working relationship where I'm gonna tell my clients once a month, go see Doc, because it's like getting your teeth cleaned, it's it's something that's gonna be valuable for you. And and to be quite honest, I don't want to spend the time going down a rabbit hole where I know for a fact I give them to you, you're gonna know exactly what it is. And that's why I'll always use this comparison where it's like, I'm a pretty good trainer. And if you come to me with discomfort and it's within my scope, I can you know do a lot with that. And it's like if the client were to say, What was it? I'm like, I don't exactly know. That's what the therapist is great at. Like they know exactly what they did. It was this thing and this process. And I don't want to be able to do that, but I want to have that environment where it's like, you know what, you your QL has been acting up for you for a good, you know, long time now. I don't want to deal with this anymore. Why don't you go work with Doc and have them take care of it? And I'm actually gonna sit on that session because I like learning about it, but I'm also not gonna selfishly take what you're doing and then try to incorporate that in the future so I wouldn't need you. It's like that working relationship, is it's only bettering everyone.
SPEAKER_00:Yeah, and I I would I would say the same thing. Like, yes, I have my SCS. Um I th I've I've thought about a couple of times pursuing a CSCS um because I like I do want to be better, I do want to be more knowledgeable, but I don't really have the interest in people's full training. I I just have the really high interest in uh getting back to sport and and training back to full capacity. So I would really much welcome the opportunity to have someone to hand off to for that overall training.
SPEAKER_01:That's interesting. So maybe it's again always not fair to say this, but a therapist with their CSCS, maybe that's something that they're gonna be entertaining in the future with more of their own training protocols. Whereas someone with just you said a CS uh uh SCS, how it's called?
SPEAKER_00:Yeah, that's yeah, that's the board certification for sports physical therapy.
SPEAKER_01:Yeah, so that's a good one to look for. And then it's just I think just having a very truthful conversation. Like, here's my goal in my business. And like you were saying earlier, we were talking, like the overhead is something that you wouldn't want. So, like if I were to have a conversation with you, hey doc, you know, let's see if we can build something up and I'll I'll front the bill for the gym, and you know, we can then work together, you can use that space. I can use you almost as I can now go out there a lot easier and talk to businesses because I'm not coming to you as a trainer. And unfortunately, but also rightfully so, people look at trainers like, oh God, here's another idiot who doesn't know what they're doing. But if I go to a lawyer firm, a law firm, and say, Hey, come to my spot. I have a therapist that's gonna take you through a really detailed assessment process. And then we now have a system where you work with the trainer that gets you moving the way you want to, but then you have that plan with the therapist as well. So that synergy is just gonna be a lot more attractive for both ends because now you can get some residual business on the back end where you don't have to go out there and try to find those patients, which I'm sure is equally as challenging for you. Would you agree?
SPEAKER_00:I would wholeheartedly agree. The the biggest challenge before I was a uh, you know, you just get people walking through the door and you get them fed to you, and like that's that's great for business. Um, for me, with my special interests and wanting to work with athletes and whatever, like I'm not saying I don't want to help everybody because I do, but you know, there are just some diagnoses that walk through the door, and you're like, Yeah, you know, I I'm just not very passionate about it. Um, and so yeah, now the challenge is now I'm out on my own. I'm I'm working exclusively with the people I want to, but it's kind of one finding them, and two, just like probably in the same way that you're out here talking about uh qualified personal trainers versus otherwise. Um I and not to pound on my own chest, but I do have a lot of conviction in what I'm doing, I do have a lot of confidence in how I can help people. I don't get a hundred percent of my people better, but a pretty good percentage. And just getting people to know or at least be aware that this solution exists. So, like, you know, people can walk down the street and be like, there's a personal trainer, there's a personal trainer, and not know the difference between them. Same thing. I think just like people have had experience with physical therapy, they have a an idea in their brain of what it looks like. You walk in the clinic, you lay on the table, you get a massage or stretched out, and then get sent off to do your exercises, maybe with that PT, maybe with a tech, who knows? Um, but that the experience exists where you know there's someone who has that rehab background, and then you know, the just the importance of not just getting out of pain because pain is not the end goal. There's still so much to work on once you're out of pain to help get someone back to 100% and prevent to the best that we can, prevent some of these injuries that could happen as a result.
SPEAKER_01:So now each school is obviously different, but is there a a big emphasis on the business aspect within physical therapy school?
SPEAKER_00:Not at all. I didn't get any of it, not at all.
SPEAKER_01:Not from like an overload aspect from the training side, because I know that you do a lot with the rehab prehab, but what about like overall programming and such?
SPEAKER_00:I we we get a little bit of exercise programming. I and I say a little bit, we kind of joke, but it's almost not a joke. When you go to PT school, you really just learn how to not kill somebody. Like that's that's where the doctorate part comes in, is because we can screen. Like, there have been a couple times where I would have an eval placed on my schedule and I would look at them and test a few things and be like, you know what? This the pain that you're having is not musculoskeletal. That's something else. You need to go back to the doctor. And you know, sometimes it's cancer, sometimes it's whatever else. And so that's what the doctorate portion of the PT degree is is being able to screen for different types of ailments or different systems. And then as far as like, yeah, as far as as like the schooling, we we would get enough exercise to like be able to help people. But but so much of it, and it drives me nuts. Even when I occasionally cover in the insurance clinics, like almost anybody I cover for is giving 20 exercises, dose debt, two sets of 10, three sets of 10 if they're really ambitious, and like the load is way underdosed. And so I walk in there and you know, usually the PTs give me grace to do what I need to or do what I want. And I'll take the person through, I'll look at a few things. I'll be like, Are you okay if we do something different today? Are you okay if like maybe we only do three or four exercises, but we're gonna do them really, really well? And I almost feel a little bit guilty saying this because it's not the fault of the PTs, it's just whatever education or whatever experience they have. And uh a lot of times the patients would say, Oh, that was really different. I really like that, or that was really helpful. I feel like I really got a workout. And we're only doing like three or four exercises, but we're dosing them appropriately. So I feel like that's honestly, that's the biggest difference you'll see between really experienced PTs. I shouldn't even say experienced because I've only been doing it uh a couple of years, but maybe the more qualified PTs. Uh, I think the physical therapy profession in general just highly, highly underdoses exercise. And so the results that you get when you just dose exercise appropriately. And then the one the last thing I'll say here is just the specificity of it. And this is where the residency really helped um with evaluations, just like if you're throwing 20 exercises at someone, it's probably because you don't really know what's gonna help, as opposed to like, let's assess this and then give you just a handful of things that are actually gonna address it. So I think that's the biggest difference or the biggest way that you can tell maybe the the skill level of a of a therapist, um, one of a few ways. Uh, but yeah, I think I think that's and that's I've and uh to your point, like I've had I've had people that I've talked to in the PT world, patients that have said to me, you know, I I don't really believe that physical therapy helps. My personal trainer helps me way more. And to me, when I hear that, I'm like, man, we are failing as a profession in this area, and it's I I can guarantee you, it just comes back to they're getting those results because they're being dosed properly. So yeah, that's that's kind of my roundabout way of answering your question.
SPEAKER_01:No, I love that because I can see that you're passionate about it. And it's like I've I've talked to therapists off the record, and they're like, you know, Chris, I can't tell you how many therapists I've worked with that you don't even know how to deadlift, that don't even use a barbell. And so when you're talking about that dose, it's all you know specific. And it's just like with food where the poison is in the dose. And it's the same thing with exercise. And if you're just doing band exercises, when where's the progressive overload going to be? Are you gonna start doing sets of 300 with uh you know clamshells, or are you gonna start loading them up and and teaching that movement properly, which you know leads me into the irony of you know some of the more popular certifications like NASA? Their whole entire model is based from a physical therapist. And and I always kind of make a joke, or I'm just like a physical therapist is great at rehab, prehab. Physical therapists aren't great with general population overload, too. And I'm not saying like it by any means that I'm better than a therapist because I'm not, I don't know shit. And that's why I love working with therapists because like I learned so much from from what you guys do, but it's almost like knowing that line, and it's I ultimately at the end of the day, I think it's just ultimately it's like fear because you want to be able to provide for your family and provide and have a living. And if you have a patient or a client in front of you as a trainer, it's like, okay, well, I could send that to the therapist, but what if the therapist then takes them and I'm gonna lose that client and all of a sudden? So if you take that scarcity mindset and you wipe it away and you go, No, I'm looking out, I got in this to help people, they're gonna do it so much faster. And I just love because I I've had people that have low back pain and I can help them get out of it because it's you know, I can eliminate red flags within reason. But I have a therapist who we work directly with, but it's just so cool when they meet with the therapist and you watch, it's just like a surgeon. They're just like, wow, they are good, and they see their mind is just going, it's like, okay, here, here, here, boom, boom, boom, and they get to the solution so much faster. Whereas maybe that trainer could get to that solution, but it's like driving from Sacramento to LA, which is just a straight shot. Why would you want to drive all over to drive up to Portland and then come down? You're still getting there, yeah, sure. But is it optimal? Is it as effective and as and are you really looking out for the the client's best interest? And I think a lot of times that's not always the case.
SPEAKER_00:Well, and how much more is that client going to respect your opinion if you get them somewhere that they can get the results faster? For example, I've had people come to me and uh I would say to them honestly, like, I have no problem working with you. I would love to work with you, but I actually think you would get better results or get what you need if you see this PT. Uh, and I I think just when people know that you're not in it just for yourself, people can sense that you really care about them and what's best for them. Like, yeah, maybe you sacrifice a sale here, but then they're gonna come back to you next time they really need something because they're gonna trust that you're gonna have their best interest. And then going back to dosing, um, you kind of you kind of made the analogy a little bit to like medicine. I always say like um movement is medicine or or the way that we dose exercise is the same as we we dose medicine. Like if you have a terrible, terrible headache and you take like one tenth of a Tylenol, is that gonna be enough to make a change? Well, it's the same way with exercise. If you're not dosing appropriately, if you're giving someone two sets of 10 with three pounds, but their capability is really three sets of eight with 17 pounds. Like, are you gonna make an exercise or are you gonna make a difference in that exercise? And the answer is probably not. And you said about fear, uh, taking fear into like the PT mindset. We're we're programmed naturally to don't hurt others, don't hurt others, don't hurt others, do no harm. And what ends up happening is like if you're so conservative with your exercise dosing, like you may do no good. And so I I almost when I talk to people, I'm like, expect maybe a flare-up or two. I'm not trying to do it on purpose, but I'm trying to find that line where we are gonna make a difference, and so when you're open and honest about that communication, it usually goes pretty well.
SPEAKER_01:And I love this conversation, and it's it's a great thought experiment, but the bottom line is physical therapists have a common education, and like you're saying, you were you know jokingly, like we're taught not to kill people, but the irony with that with our industry with personal trainers is the bar is so low to use your medicine analogy where it's like trainers are giving their clients 15 Vicodin in a bottle of whiskey, and yeah, but now it's way too much. And because and I always ask trainers, like, okay, you're working at this gym lifetime, equinox, whatever. How many trainers on your team would you let train your mom? And more times than not, it's like maybe one or two. I've never had fear, like, hey, mom, you your your shoulders messed up or your back's messed up, go to a therapist. You know, looking at their credentials could help, obviously. Maybe there's gonna be a faster route, but I'm I'm not I'm never fearful when it comes to going to a trainer. I'm fearful because I don't know your background and do you really understand anatomy? And there's a trainer, Cody, who is an awesome trainer, has a PT on his team, and and he's interviewing trainers right now. And he's just like, Holy crap, man, like it's scary. Where they will check a box saying, I know anatomy, and let's have a little conversation. It's like, you know, just start off just simple stuff. Let's talk about the quads. And can you tell me the names of them? They're like, excuse me, what do you mean? It's the quads. It's like, no, there's four muscles there. Like, can you oh um yeah, you know, uh uh slipped my mind. Like, could you imagine going to a PT and be like, could you tell me the rotator cup muscles? They're like, Oh, that was so long ago, I forgot. No, no, they're always gonna remember that because of the time that you spent in that first one to two years, it's just like you regurgitate that. And I always find it funny because I'll talk to a lot of therapists and they're like, Oh, you know, I'm not that good at anatomy, and then they'll start talking about like movement and stuff, and they'll just start paraforming stuff, this blah blah blah extra rotation. You're like, no, dude, it's it's so in the real, it's just like it's second nature. But that's the unfortunate thing about the fitness industry with trainers is they don't have that foundation, and so what that affects long term is you can't have a conversation with yourself because if I were to go to you and I and I read my upper cross syndrome from NASA Morace or whatever, and I'm telling you that the the ups, the upper traps are overactive, and and then you maybe challenge me, well, maybe it's something more distal. And I'm like, distal? What what does that mean? And you're like, whoa, uh that's like basic, basic stuff. And trainers don't have that capability to have those basic conversations with other medical professionals, and so when you do, then it's just like it's a whole new world because the the therapist is appreciative because they're like, Wow, you know, you're not some meathead who's just doing you know crazy back, you know, flips on a bosu ball or doing crazy shit. It's like you're actually competent, and it's a it's a fresh breath of air because we will get compliments from therapists and be like, dude, you're you're better than some of my coworkers and they're therapists. And it's just it's not to say that we are therapists, but it's like, uh, we can have a synergy. And it's really cool that I can talk to you almost on the same level where you can say, Chris, uh, this this client's coming in today, don't do this, you know, consult education here, blah, blah, blah. I'm like, okay, I understand what you're saying, but you have that confidence to pass them off to me. And if we have more of that, I think both parties win because then the business side, you're gonna have more business coming through your your clinic versus you have a little gym. And so it's like there's so much work that needs to be done. And I've been pounding my head on a desk for I was like, have a therapist get an RD on your team, and now you're stepping away from the societal viewpoint of you know, trainers aren't that smart, you're now completely different because you have that team.
SPEAKER_00:Yeah, and it works both ways. I think the first thing is that like whether you're a PT or a personal trainer or whatever job you have, like one, striving to be better and wanting to learn more so that you can help more people, but two, also kind of knowing your limitations a little bit. Like, I will say it's going off topic a little bit here, but it's relevant. So, like pelvic flora therapy is like a really big growing area of physical therapy. I know probably more than most like sports or outpatient PTs about that because I worked side by side with one literally one of the best in the world, Ashley Crew. And but if someone came to me with like what I thought was pelvic floor dysfunction, like I know some stuff, but I like I'm not I'm not the one to help you. So again, just like knowing your limitations, having a network of people where you're like, okay, for this problem, this is who you go to, for this problem, this is who you go to. For this one, I can help you with this. So I think just one being humble, being hungry to better yourself, and just like, yeah, build a network of people that just allows you to help people better.
SPEAKER_01:Now that you're cash-based, what's one of the hardest parts of your job?
SPEAKER_00:Um two things. One is marketing, because I am an introvert by nature, so it's really hard to push myself out of my comfort zone. I've I've done a lot of self-work with my business coach over the last year, and he has helped me tremendously. But, you know, it's it's always pushing myself out of my comfort zone. And the the second part is sales, and those are two things that you don't get in PT school. Uh, I'm also an athletic trainer, it's two things you definitely don't get in athletic training school. So they're just two skills that for the past year I started at zero, and now I'm having to learn those skills as well. Actually, when uh Pojan um kind of introduced your name to me, uh, he sent he sent me one of your podcast links and I started listening to a couple. And the one that you did on sales and how to make a sale and how to um have that interaction was extremely helpful. And in the back of my mind, I'm like, man, like that's that's a skill that you have mastered and that I have such a long way to go. Um, and I I think I touched on the other thing earlier is people just like don't quite know exactly what I do, despite what I put out on Instagram or the conversations that I try to have with people. Like when they hear a physical therapist, they think, again, go to the clinic, lay on the table, do this, this, and this. But what I'm doing is really much different than that. And to have people understand that or have people know that, and the people that have come to me and have known what I do, it's like, yeah, the sales already been made. But for people that are expecting similar things to like a PT, a traditional PT clinic, you know, then then you get into the questions about like trying to trying to show value in what I do, because paying out of pocket is much different than having insurance pay. Um, so I think those are those are probably the the big ones.
SPEAKER_01:I always make a joke and say I'm a selfless trainer, and I say that jokingly, but also it's like my natural intuition of constantly learning. When I meet with a therapist, I always want to learn something new because you see so much stuff on social media, and you got someone like Adam Minkins who's just bashing certain stuff that some people are doing, and you got more, you know, they call them like charlatans, and you see some people like Squat You or whoever they have a huge following, but they're doing some stuff, and you're like, hmm, I wonder if there's what is the intent behind that because it's so beautiful and how they market and they use the sales techniques within their their page, and so they may implement a screen or something, and then off topic. But could you tell me a little bit more about the Faber test and how it would be incorporated with the client?
SPEAKER_00:Yes. So I I'll say I'll say this first. I'll answer the question, but there's I I look at special tests a little bit differently now than I did before PT school, and especially now, even after PT school, because any one individual special test is gonna have really variable results. It depends a lot on how you perform it, it depends on a lot of factors. When I'm testing for things, um, I try to use what we call test item clusters. It's what research has deemed um, you know, if you do these five different tests in a cluster and three out of five are positive, then this likelihood exists that the whatever's important or whatever, um if it's there or not there, if it's ruling in or ruling out. As far as favors goes, like when I I look at that, like you you could be getting a little bit of like intra-articular considerations with the hip, just depending on how that how that hip is moving. I almost look at it a little bit differently. Like if some we'll take like hip impingement, for example, or something more with the anterior hip. Like there's so much stuff out there with hip impingement that, like, oh, it's happening because of this the the bony prominence, whether it's on the acetabulum or on the femur. But a lot of the times that happens because like posterior hip is tight or posterior capsule is tight, they go into a hinge or they go into a deadlift and they can't access that range of motion in the posterior hip. So therefore, the anatomy starts getting pushed forward, and then you start having these pathologies. So I know I didn't exactly answer your question, but I kind of think about it a little bit differently, where like anyone's special test doesn't really give me all the answers that I'm looking for. It's it might be a good starting point, but um yeah, that's kind of that's kind of my thought.
SPEAKER_01:No, I I love that. I just I I tell trainers it's better to be over informed than underinformed, where it's like it's it's not this, I wouldn't I can't I can't do a Lockman's test, but I'm familiar with what it is. And I it's not like you're gonna, and I could be wrong, but I don't think a therapist is necessarily gonna look down upon a trainer if they don't know certain tests. But I think at the same time it's gonna give some credibility. I'm not doing these tests, but if you were to say, yeah, you know, I did a favor test, like I'm familiar with it. It maybe it kind of gives you that a little more credibility because you are you're familiar with the medical space and the therapy space. And that's why I encourage trainers, and that's why we have our soft tissue certification where it's go intern under a therapist, get into a clinic. It doesn't matter if it's insurance-based or cash-based, but just be around the environment to see how they talk. And what that's gonna do is it's just gonna raise your confidence, but also it's gonna, I feel like it makes your sales job a lot easier because you have the team. And and again, it just comes back to it's like full circle. We can learn so much as trainers from therapists, and I think that therapists can learn from trainers, and it's just a win-win for everyone.
SPEAKER_00:Yeah, and just to go to your point there, I I would never expect a personal trainer to like know special tests or how to perform them, but it like if you know the names of them, or more importantly, if you know maybe some of the implications of them, like that's gonna make it so much easier to talk back and forth. Um, because then I can I can know that you know, whatever I'm saying, you at least you would understand what I'm saying, and you also know like the next step of okay, this is a positive test, or that these this item of uh the cluster test is positive, like this is what we're dealing with, and then be able to talk through like, okay, how do we get them better?
SPEAKER_01:I would it'd be interesting to see how many trainers it just flew over their head when you said acetabellum, you know, acetabellum. I always mess it up. I just say it fast with confidence, and it sounds like you know what you're talking about. But I bet you a lot of trainers are like, shoulder is that the ankle? I don't even know the name of the ankle bone, but I think in just those conversations, you'll hear that anatomy being dropped. And like you're talking about a specialized test, and I'm just visualizing everything you said. I'm looking at the hip and how it's articulating, and it's just those are the conversations that I have expectation wise for trainers. And when you can level up your anatomy, I think it just it's gonna make your whole career significantly better and easier.
SPEAKER_00:Yeah. And my my evaluation, the way my brain works, I I've I've learned to appreciate it a little bit more. Than I used to. But even like in evaluations, new patient comes in for an evaluation, like my brain was trying to fit into the like assessment that either we were taught or the assessment that you know the the computer in front of you like tells you you need to look at or whatever. And I've I've just always had a hard time putting information together that way. And one thing that I've learned, or one thing that I've been able to express a little bit more now that I'm on my own, is like just kind of evaluating within the way that my brain works. And it seems to flow a lot better because I don't have a really hard time, believe it or not. Uh maybe I shouldn't admit this on air here, but uh like I'm not the greatest at diagnosing like a specific injury. Like, yeah, there are some things that are really common that you see over and over again, but the way my brain works is like more on a tissue level. So like someone comes in with pain, what we'll say, we'll say hip pain, pain in the front of their hip. My focus isn't really like identifying what the diagnosis is. It's my I always question like, why is that happening? And so then when I chase the why, then I start testing things that could affect why it's moving that way. And then you end up with things like, oh, posterior capsule's tight, can't glide backwards, therefore it's pinching in the front, like like that kind of stuff. So my brain kind of works in a little bit different way, and I'm starting to embrace that a little bit more now. Um, but yeah, it's just kind of funny the the evolution and and more the the freedom that I feel that I have now to look at things in my own way.
SPEAKER_01:And that's the beauty of critical thought. Is that something that you think you learned outside of the education system that you went through? Or is it kind of is it like that Neo moment where they're teaching you for a reason, and the critical thought is part of the the foundation of the the program you're going through. And then it just kind of hits you, and you're like, oh, okay, now I'm starting to understand the why, and I'm chasing that why. I'm not just being you know a cog in the machine and doing all these random things.
SPEAKER_00:Yeah, I I think when you're learning anything for the first time, so you're you're a student in PT school, you're a student in whatever school, you're a brand new professional, like the more structure you have, the better, because then you can get repetitions of doing things over and over again, and it starts to that's that's how we learn is with repetition. And so there are some things in life, some skills or some ways of thinking that you know I would go within the structure, go within the structure, but like I still felt like I was missing part of the picture. And now that I just have the freedom to do things the way I want or look at things the way I want, I just feel like everything has become more clear. And yes, that is more the critical thinking. Um, but I I did need some foundation of structure to start. And then as you get a little bit more experienced, and you know, again, now that I have the freedom outside of the traditional structure, um, I feel like I can express that a lot better and and help people a lot faster.
SPEAKER_01:I love it. We we just released our our 300th episode, and I have to say that this has been one of my most enjoyable conversations I've had. So I appreciate your time, doc. This was enlightening. Love to meet you in person one of these days and and just to pick your brain even more and continue to better the field. So thank you.
SPEAKER_00:Yeah, I I really appreciate the opportunity to come on and uh hopefully we'll see you on my podcast sometime soon.
SPEAKER_01:Absolutely. Where can people find you?
SPEAKER_00:Uh I'm on Instagram at higherpower sports pt. Um, and I also have my own podcast, like I just alluded to, where I talk about sports medicine topics and uh topics in uh faith, and that is the higher powered podcast. So probably the two two easiest places to find me.
SPEAKER_01:Go give them a follow, say hello, give them a five star review for that podcast. And thank you, sir. Happy New Year, and we'll be chatting more.
SPEAKER_00:Okay, see you, Chris.