Interview with Justin Moore, PT, DPT

Many of you (my readers) have requested that I interview Justin Moore, PT, DPT, (@policy4pt) the ATPA’s lead lobbyist on Capital Hill. And, it finally happened!

We touched on a variety of topics in addition to focusing on the APTA’s engagements in the political & advocacy fronts. For more info on things related to the APTA and Political Action check out this page.

Without further delay, here’s the interview. Enjoy!


You’ve got a unique professional story! You went from graduating College with a degree in Dietetics to Executive Vice President of Public Affairs for the APTA. Tell us your story. How did you get to where you are today?

I hope the story is still evolving. The chapters to date have been shaped by merging personal interests with the required education to practice physical therapy and be part of a profession. I came to physical therapy through an exposure and interest in serving individuals with disabilities. Dietetics was an early chapter by introducing me to the role of public policy and its impact on the health of communities.  Once in physical therapy, I found an environment that encouraged me to combine my interest in politics and public policy with my passion for my profession to begin to build a career. This was encouraged by Jayne Snyder early in my career which lead me to volunteer at the chapter level. These volunteer experiences led me to APTA’s federal and state forums. I joked to the Director of Government Affairs at the time, Nancy Garland, that she needed a PT on her staff. About a year later, she called to see if I was interested in joining staff. Being young and cheap, I was able to take this chance and begin to learn public policy, advocacy and government affairs from a great group of professionals at APTA. I hope this experiment APTA took on me 15 years ago has also opened doors for other PTs to seek non traditional career paths. The chance the organization took on me has been extremely rewarding and never short of challenge on a personal and professional level.

Let’s say someone at a non-PT event asks you “What is Physical Therapy?” How would you respond?

Physical therapy is about helping people get back what they have lost in their physical function and health.  Physical therapists are the bridge from what you currently cannot do physically to what you want to do.  Restoring movement to enable individuals to participate in their home, their work, their sport, their pursuits, and their communications is our core mission and purpose.

Since you have such a strong background in the public policy facet of Physical Therapy, what should every current and future PT know about how to push their profession forward?

To push the profession forward, you need a firm footing in the current public policies that define the profession and determine how, where and with whom we can practice. Understanding and appreciating the state practice act that defines physical therapy scope of practice is both the foundation and the opportunity. This policy provides the platform for recognition by payers and public programs, but also set up our potential to continue to advance our profession. To realize the opportunities ahead we need physical therapists to participate in public policy process from advocating on PT issues to community involvement to show our impact on society.

What is the biggest hurdle to complete Direct Access across the nation? What is the APTA doing toward this effort? And, what can PTs do to further fuel this effort?

Direct access is quickly becoming a reality. All 50 states have some form of direct access and we are seeing more rapid recognition by payers and the public at large. Direct access will only be a part of the equation as we will need to use this authority in different and new ways. Direct access has been incorrectly seen as our desire to seek independent practices and not as a mechanism to build collaborations with other healthcare professionals. These collaborations and partnership will be the next phase of demonstrating the importance of direct access to our practice and our impact on health care. APTA is seeking efforts to continue to expand commercial payer recognition, building the data case on direct access to show its use and value and efforts to educate the public on physical therapy and when to seek the care and services of a physical therapist. PTs should engage in their clinical environment, with their patients, and with payers to ensure that direct access is utilized and leveraged to improve our health care delivery system.

Pick one of the following you want as a Mentor? And why did you choose him/her?

  • Clark Kent (Superman)
  • Wonder Woman
  • Bruce Wayne (Batman)
  • Tony Stark (Ironman)
  • ______________ (your choice)

My knowledge of superheros is sparse, but I’m going to go with Bruce Wayne. I appreciate that he has become a superhero without a significant superpower. His message of leveraging your strengths, being resourceful, and building wisdom through experience and study have made Batman unique in the superhero space and I would love to have that mentorship.

What’s standing in the way of Dry Needling falling under the scope of all Physical Therapists across the US? How can PT’s help?

Physical therapists have been performing this intervention for years and clinician use is increasing. This intervention has also recently been subjected to the classic turf war of one profession seeking to have exclusive rights to this interventions. APTA is seeking legislative, regulatory and legal avenues to allow physical therapists to continue to use this intervention consistent with their education and training. PTs can help but understanding this public policy issue, educating their elected officials, and support efforts in states that are currently defending PTs ability to perform this intervention as part of their practice.

If you could speak to every PT in the US, then what would you tell him/her?

Remember why you choose the profession and keep that front and center every day. It is easy to get discouraged by the changing healthcare environment, the increasing demands, and all the distractions that pull physical therapists away from their purpose of service.

I would also tell every PT to never forgot that your license is yours. You’ve invested the time, energy, and intellect to have the privilege of a license, don’t underestimate it’s value, its potential, or ever compromise it.

Your calling to the profession and protecting your ability to practice by your license will serve you well and allow you to be a part of this great community of caregivers and clinicians.

Favorite books and/or authors? Any recommendations?

I’m not a voracious reader but have attempted to spend more time in books when on the road traveling and in the evening as my children read.   My favorite book is To Kill a Mockingbird (H. Lee). I’m currently reading Go Set a Watchman (H. Lee) and am disappointed in the start and struggling to stick with it.   

I would recommend Boys in the Boat (D. Brown) and Rome 1960 (D. Maraniss), both great story about young men and women coming of age in a changing world. They both have an Olympic thread as well which is an interest of mine as I love the Olympic movement, its history and the drama of each edition of the games. Lastly, I would recommend The Road to Character (D. Brooks). I bought this book for a friend that had just given an eulogy and was captivated by her remarks and the concept of eulogy virtues and how society is moving way from these virtues.   The book has one of my favorite lines and life themes about the importance and value of long obedience in the same direction.

Tell us about the Physical Therapy Outcomes Registry. How has it been going so far?

The registry is the project and initiative that I have been most excited about for some time. It’s potential is profession-changing but not without its significant challenges. The excitement and potential of the registry must be tempered by making it meaningful and easy to participate in at the clinic level. We need to systematically build the registry over the next several years and try to learn from each step and improve its utility and its value to clinicians and the profession at large.

The major hurdle for the registry and public launch of this platform for widespread participation is integration with electronic health records through an established sets of standards. Progress is being made but not at the pace we would like to see.

Do you have any passions or hobbies unrelated to PT?

My emerging and growing passion is about the importance of service and how we can participate in our communities to improve their lives and health. My particular interest is sports, recreation and physical activity for individuals with disabilities or significant impairments. I have two colleagues, one that volunteers with a little league baseball team for children with disabilities and one with a ski program. They both have my admiration and have sparked a desire to spend more time in service. My wife and family also have a passion to address hunger issues locally (comes from both my wife and I’s background in dietetics and nutrition). The number of children coming to school hungry in our neighborhood and community is unacceptable and if we can help one kid start their day a little better off than the day before, we want to help achieve that.

Since we’re coming up on an election year, is there anything we should consider in terms of Impact on Physical Therapists across the US?

The biggest impact physical therapists can have in elections is by actively participating. Educating candidates on the importance of health care and physical therapy to our communities and economy is essential. Our role and potential is still not widely understood, appreciated or leveraged. With the power of our collective profession participating in the electoral process, we can take great strides in realizing our role in improving the health of our patients and our communities. We also need more PTs to run for office. We have 11 in state legislatures but we need support and encourage more PTs to seek public service at all levels.

You’ve just traveled back in time and are sitting face-to-face with your 30 year old self. What advice would you give yourself?

Slow down to listen and learn. I was at times in a hurry when I was younger and didn’t take the time to observe, learn, and listen to some experienced leaders in the profession and public policy. Looking back the time spent talking with friends, listening to leaders, and learning by observing how one approached an issue, carried themselves and developed their thoughts was never wasted. Those opportunities always centered me and prepared me to be more aware, more knowledgeable and more engaged but I didn’t always seek them or appreciate them at the time.

Why doesn’t the PT profession have a super-PAC where anyone can donate money for the cause of strengthening ourselves on the political stage?

The physical therapy profession has an established and well regarded political action committee, PT-PAC. PT-PAC is the political action committee of the American Physical Therapy Association and a connected PAC. This means the PAC is limited to soliciting funds from a restricted class (APTA members) and distributing those funds in a transparent and regulated process to directly support candidates that are friends of the physical therapy profession. PT-PAC currently is a top 10 health care provide PAC with about 10,000 donors annually.   Our position on the political stage would be enhance by a greater market share of licensed PTs being members of APTA and a great percentage of these members contributing to to PT-PAC over the creation of a Super PAC in my estimation.

Super PACs are independent expenditure committees that do not make contribution directly to candidates but engage in unlimited political spending independently of the campaigns. These PAC are not subject to donor limitations as well and do more broad base issue advocacy. Due to limited resources and the cost of operating a Super PAC, APTA has focused its efforts to build the strongest, most effective connected PAC (PT-PAC). I also believe for a professional society that a connected PAC is most consistent with the role and purpose that these societies have in advocacy and public policy. Nothing restricts a SuperPAC from being established with its focus to advance physical therapy but I am also unaware of any significant or serious developments to form a Super PAC in PT and would encourage more widespread participation in PT-PAC over creating a Super PAC.

Share something about the APTA that most Physical Therapists across the country would/wouldn’t think of.

I think most physical therapists think of APTA as theirs and that is essential. APTA is and has always been the organization that physical therapists can call their own. APTA  is a collection of PTs that are set on protecting and advancing the profession. It will not solve the problems of PTs today or achieve the profession’s priorities without participation. Over our history many PTs as part of APTA have build a great foundation that all of us benefit from today. It’s our responsibility to participate, shape and add to the story of our profession for the next generation and continue to make APTA all of ours.

You’re a busy guy! Do you have any daily routines that keep you on task?

My daily routine is always better when I get a run in. I run for both mental and physical health and need that time on the trail or treadmill to think, plan and dream. I notice when I miss more than a day or two of running, I begin to slide in productivity and time management. I also like to run for solitude, no running partner, no iPod. My wife is the perfect running partner as we have trained for a marathon together and I bet we run for hours without saying a word, just both thinking and enjoying the steady pace. Another daily routine I’m working on is becoming a morning person. I have always worked late and been more of a night owl, but I am beginning enjoy starting the day earlier, doing some daily reading and getting my kids on the bus. My 9 year old son likes to play catch (baseball and football) as we wait for the bus and nothing starts the day better than tossing the ball around before meetings, emails, and time at a desk.

Justin, thank you for taking the time to share your thoughts & experiences! It was very informative and spotlighted the importance of a united effort on the political front.

Connect with Justin Moore via twitter: @policy4pt

And, find me @Cinema_Air

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Interview with Chris Johnson, PT – Part 2

This is Part 2 of my interview with Chris Johnson – @ChrisJohnsonPT. Read Part 1 here. If you haven’t already, then head to his extensive library of Youtube videos that are well worth your time if you’re interested in specific exercise drills for rehabbing a variety of running injuries and more.

You can find Chris in person at Zeren PT in Seattle, WA.

There’s quite a bit of practical and pragmatic advice in here. Enjoy Part 2!


There’s an interesting overlap between coaching & being a Physical Therapist. Tell us about it, and how you’ve blended the two together.

First off, I’m glad that you see and appreciate the overlap. Being a physical therapist as well as a certified performance coach puts me in an incredible position to help athletes of all ages and abilities.

Considering the fact that we are human, and most likely have some remarkable past medical history or happen to possess subclinical pathology or certain risk factors for injury, it’s critical to first identify and address those risk factors so they do not come back to haunt us down the road. The bottom line is that things exist on a spectrum. All too often, I have athletes who are looking for coaching that really are candidates for physical therapy. Being able to effectively triage an athlete is critical to foster outcomes and reaching performance objectives. As I always like to tell folks, “you rehab to train, you train to compete, and you compete to redefine your limits.” It’s also funny that I’ve somehow gotten pigeon holed into being known as a running injury expert.

Considering that triathlon is a head to toe sport in every facet of the phrase I must have a solid command of the lower extremity but also of the spine, shoulder girdle as well as various bodily systems and how they interact. While I feel like I do a good job of staying current with the medical literature, I work tirelessly reading the performance literature to put myself in the ultimate position to ensure my athletes are ready come race day, or as I like to call it “harvest day.” In addition to being in a good position to help those seeking my services, I have also greatly benefitted from being a PT and coach when it comes to my own training and racing. When people ask me why I race, I often respond, “To find out how good my understanding and application of the medical and performance literature truly is.”

What are some of the most prevalent myths surrounding Performance Training?

In terms of triathlon, the greatest myth is that athletes are at a lower risk of injury considering the multi-disciplinary nature of the sport. The unfortunate reality, however, is that triathlon is a “triple threat” for injury, as Bruce Wilk likes to say. Triathlon involves three separate disciplines each with unique performance demands and risk factors for injury. Throw them all in the same pot and you invariably get a lot of over-trained, injured athletes who fall into the deep, dark abyss of a medical system that lacks the understanding to properly helm them. The other common myth as it relates to multisport endurance athletes is that weight training will only bulk one up and impair performance. The research shows that nothing could be further from the truth. Strength training has been shown to almost halve overuse injuries while improving economy of motion and rate of force development. Needless to say, if there is one thing that an athlete should do beyond their usual training for their discipline(s), it’s strength train. People would be surprised if they spent a week with me to learn how much I lift and perform drills. The irony of the situation is that most of the athletes that I work with always think I have a contrarian view until they realize that most everything I apply to their programming is based on the available body of medical and performance literature. The last myth, which continues to amaze me, is how much water endurance athletes think that they need to consume. I always laugh when people ask me how much water I drink when I compete in Ironman races. The answer is always zero, aside from occasional rinsing to clear any residual sugar from the gels and sports drink. Water does nothing beyond slosh around in your stomach while racing. It particularly leads to problems on the run secondary to all the jostling. Lastly, one of the myths among endurance athletes is that one can maintain race ready fitness year round. One of my greatest pieces of advice is to briefly lose fitness for a month. Once people get on the wheel, however, they can’t bring themselves to step off. As I always remind folks, if you don’t take planned time off and rest days, you will end up taking forced time off and rest.

This might be my favorite of your blog posts! Let’s dive into a parallel story: your knee that beat conventional thinking & carried you through the Ironman. Tell me about the journey you took to overcome your knee issues. What have you learned? How have these lessons affected you as a clinician and as a competitor?

This response could easily turn into a novel so I’ll spare you and give you the condensed version. At the age of 16, I remember the first time that I sought orthopedic consultation for a knee injury, which was aggravated by stair descent as well as when I was lining up to hit a backhand while playing tennis.

Naturally, my mother dragged me to local orthopedist for further examination. The physician’s office was a cold, sterile, and unwelcoming environment. After waiting for what seemed like an eternity, I finally was called back to see him. After talking to me for no more than a minute, and taking my knee through an orthopedic examination, he sent me for xrays down the hall. Once they were ready, he placed them on the stereogram and proceeded to point out an osteochondral lesion involving the right femoral condyle. He then muttered that I would most likely have to give up tennis and would never be able to run the rest of my life, “unless a miracle had occurred.” I did not place much faith in his words as I thought to myself, this guy talked to me for what felt like a second and failed to offer any meaningful solution to my problem. Fortunately, I sought a second opinion from Dr. Freddie Fu, a world-renowned orthopedist at University of Pittsburgh. Upon walking into his office I knew I was at the right place as his waiting room was filled with autographed pictures of world-class athletes. When he came in to see me, he also exuded professionalism, which was not hurt by the fact that he had a team of literally 10 residents and fellows following him around. He ended up having me go non-weight bearing for eight weeks before scoping my knee. Following surgery, he prescribed PT and recommended that I connect with Steve Hoffman, a well respected PT in the greater Pittsburgh area, who helped me return to playing tennis at an even higher level than before. Fast forward to my senior year of college when I was playing tennis in Florida as part of a Spring break trip which our team took every year. I was in the middle of a tight match and running full speed when I abruptly stopped and felt a sharp sensation in the anterior aspect of my left knee this time. Although I somehow managed to finish the match, I went to step into the team van afterwards and felt a strong, stabbing sensation and saw stars.

After returning to campus after the trip, I sought orthopedic consultation by the top knee surgeon in Delaware, who initially injected my knee, and had me undergo a bone scan as well as an MRI. Upon reviewing the results, I was told that the bone scan “lit up like a Christmas tree” and that I “had the knees of an 80y/o.” He diagnosed as having an avulsion fracture of the inferior pole of my patella. I also managed to get a copy of the MRI to read, which stated that I had no medial meniscus, severe degeneration of the lateral meniscus, severe chondromalacia of the patella, and bone erosions. I can’t think of anything more threatening! Although it took nearly a year before I could finally ride a bike without pushback, I finally took up road cycling. I used to always mountain bike before that, but shifted when I stopped to consider the smooth cyclical nature of the activity and how it would engender a great environment to restore the health of my knee. After a few years and several thousand miles under my belt, my knee started to feel really good again. I was no longer having any issues with walking around the streets of NYC, where I was living at this point in time, and was also tolerant of climbing stairs. Naturally, this prompted me to make an attempt to return to running.

Over the next several years, I slowly build my capacity and tissue tolerance to the point where I was running consistently while developing even great confidence in my knee. It was in 2007 when I competed in my first triathlon. Since taking up the sport, I have been injury free while racing for the past eight years and have been to Kona twice without having any signs of slowing down. I always make it a point to share this story with my patients to remind them of a few key things: 1) the body has a remarkable affinity to rebound from injury, 2) be careful of getting too attached to diagnostics as anytime you go into a tube there is nothing good that you will find out and 3) always remain patient and pro-active while ensuring that you have an accurate understanding of your situation.   

Pick one of the following you’d want as a Mentor? And why did you choose him/her?

  1. Jason Bourne
  2. Wonder Woman
  3. James Bond
  4. Tony Stark
  5. ____________ (not listed)

Bourne was the ultimate combination of intelligence, strength, skill, and getting himself out of seemingly impossible situations.

You have an incredible collection of Youtube videos! How do you come up with so many clever drills??

I first got into video recording when I used to spend my days skateboarding, snowboarding, pitching, and playing tennis among several other activities. I was always blown away by how much information one could pick up from going back to watch the tape. It’s pretty funny that I’ve continued to capture video through my professional career. While still in NYC, I initially started recording video of exercises and drills that I routinely prescribed to patients to ensure that I was providing a solid model of performance. I would record an exercise then go back to the camera to watch and would always find some aspects that needed to be changed or refined. Not only did these vids improve my own movement skills but they also started to comprise a video library for patients that I was working with in the clinic as well as a resource for folks across the globe. While we are on this topic, I think that is one of the greatest opportunities for improvement among clinicians and graduate programs. Therapists, similar to kids, need playtime and exploration to really enhance their skills when it comes to exercise prescription and demonstration.

One of my rules of thumb is that if I can’t demonstrate an exercise that I’m prescribing, then I need to either find a video that highlights keys to success or refer that person out to someone who is in a better position to help them reach their goals.

Let’s stick with the videos for a bit. Tell me what I need to do so that I too can produce sharp videos like yours.

First off, no need to spend a lot of money on fancy gear. At this point in time, all you need is a smart phone to be honest. Otherwise, everything is pretty much free. I suggest creating a Youtube or Vimeo account, get acquainted with Imovie, and start setting aside one day a week to shoot a bunch of videos. Of greater importance is to keep the videos, short, sweet and relevant. Also try to minimize clutter in the background to avoid distracting the viewer. No need to make the videos flawless either. It also never hurts to give people context. A prime example of this is when the police sirens would start up in NYC around 4pm (most likely when happy hour at the bars got underway). I used to always try to reshoot the videos, but I started to just keep the siren background as it gave viewers context considering that NYC is known to be a noisy, chaotic city. Lastly, if you plan to put the videos online, make sure to stay consistent with posting content otherwise your viewership will fall off a cliff.  

Favorite books and/or authors? Any recommendations?

Shel Silverstein: Where the Sidewalk Ends.

Otherwise David Sedaris is perhaps my favorite author. I remember reading his books while traveling on the subways of NYC and cracking up. I also like Jon Krakauer’s books in addition to any of Mark Twain’s stories. These days, however, I find myself reading “What to Expect When You Are Expecting” considering that my wife and I are expecting a baby girl in Jan 2016.

[Congratulations on your upcoming baby! She’s a very lucky girl!]

You’ve just traveled back in time and are sitting face-to-face with your 25 year old self. What advice would you give yourself?

  1. Remember that health and friends are the ultimate currency.
  1. Take money, sex, and power out of your decisions and you will never make a bad one.
  1. Read one research article per week.
  1. Never start your day checking email or social media.
  1. Make sure to read something funny before you go to sleep every night.
  1. Have transparency with others even if it upsets them as it will ultimately foster trust.
  1. Never buy more than one car per household and avoid it at all costs if you can.
  1. Make sure to learn another language.
  1. Spend a lot of time around professionals in other disciplines as it will only give you more refined understanding of your own.
  1. When you sit down to eat, make sure to do nothing else.
  1. Cardiovascular exercise and strength training are very important and one should never be done entirely to the exclusion of the other.
  1. NOW HERE or nowhere. I recently learned this from a friend, who used it when he was the MC of a wedding. I can’t think of any greater piece of advice considering the distracting world we live in. When you spend time with friends, family, and colleagues, make sure that you are present with them. You never know what you might be missing.

Chris, thank you for taking the time to do this fun & detailed interview! I learned tons, and I’m sure my readers have gleaned some great info. Thanks again!

Connect with Chris on twitter: @ChrisJohnsonPT

Find Me: @Cinema_Air

Book Review: You Can Run Pain Free! by Brad Beer

I had the pleasure of interviewing Brad Beer last year. It was a fantastic interview – I learned a ton.

Not too long after the interview Brad published a book titled “You can run pain free!” For full disclosure, Brad provided me with a copy of his book for review – Thank You!

My verdict: It’s worth your time.

Physiotherapists and other clinicians will benefit from Brad’s pragmatic blend of research and reality. The book also provides the general public with a solid background of how to evaluate themselves, progress their running, and communicate better with their Physiotherapist when needed.

5 REASONS THIS BOOK IS WORTH YOUR TIME

IT PROVIDES A GUIDING FRAMEWORK. This framework puts the novice runner into a better first step, and can give him/her a more nuanced view on efficient and pain-free running than the average new runner. Many weekend and seasonal runners can also benefit from this book for the same reason: they are now equipped with tools for faster and pain-free running.

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PSYCHOSOCIAL PERSPECTIVES. Brad does a very nice job integrating the psychology of running injuries and their impact on returning from injuries. His views on this are beneficial to both runners, as well as Physiotherapists who work with runners. Here’s one of my favorite passages on this topic.

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METAPHORS & COMMUNICATIONS. It is becoming ever-more clear that the way we (Physio’s) communicate with our patients has a direct impact on their recovery. Brad uses a variety of metaphors in his book to steer the runner into a healthier mindset that allows him/her to believe in their own potential. This alone is worth the read for clinicians and runners in general. His concept of “Frame Weight” is one of many clever expressions peppered through the book.

MORE THAN THEORETICAL. While Brad cites published literature throughout his text, he manages to integrate the lessons he has gleaned from his personal and professional empirical distillations. A nice example of this is his perspective on overtraining.

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OPPORTUNITY TO LEVERAGE BRAD”S EXPERIENCE. Brad experienced a knee injury that eventually underwent surgical repair and was told that his running days were behind him. Well, time has proved those words false. Brad completed the NYC Marathon in 2015!

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How did he do it? What did he learn through his years since his knee injury? What can you learn from his experiences? You Can Run Pain Free! is a synopsis of what he has learned and applied over the years. It’s more than an academic exercise, it’s a pragmatic text based on his personal & professional experiences.

Here’s a quick blurb Brad posted just prior to his book launch.

You can pick up You Can Run Pain Free! here.

@Cinema_Air

Interview with Chris Johnson, PT – Part 1

If you haven’t heard of Chris Johnson (@ChrisJohnsonPT), then you’re missing out. First, check out Zeren PT, then head straight to his extensive library of Youtube videos. Chris was also interviewed by Karen Litzy on her Podcast on Working with Endurance Athletes.

The interview provides a glimpse into how Chris has accomplished what he has so far, and what we can glean from his experiences. It’s so jam-packed with practical info that I decided to break it into 2 Parts.

Here’s Part 1. Enjoy!


So, how do you start your day? (breakfast, routines, etc…)

In all honesty, it depends on how much I had to drink the night before. By no means am I a boozehound but I do like drinking beer and happen to be in one of the best places in the world for doing so. I’m definitely not a typical endurance athlete, who is a slave to their training schedule and wakes up at 5am to train. Rather, I prefer to have a cup of coffee and read some research or catch up on world events. I also find myself doing a significant portion of my writing in the morning. One of the biggest mistakes I used to make in the past was top check my email or get on social media first thing in the morning. This undoubtedly stifled my creativity, as I’m definitely more lucid during the morning hours and need to take full advantage of this time.

Tell us about your orthopedic/sports graduate fellowship. Why did you decide to do it? And, given the benefit of hindsight, how has it impacted who you are today?

I had the distinct privilege of working in Dr. Lynn Snyder-Mackler’s lab in the UD PT department as an undergraduate, which morphed into a sports/orthopedic graduate assistantship at First State Orthopedics under Dr. Michael J. Axe. All in all, I ended up spending two years completing a Peter White Fellowship under Lynn as an undergraduate, which allowed to be a co-author on a couple manuscripts while spending nearly three years with Dr. Axe. Dr. Axe had an incredible work ethic so I was able assist him in seeing patients. He really taught me everything about clinic care and daily operations of running an orthopedic practice from the bottom up. These two individuals undoubtedly shaped my work as a clinician and demanded me to stay on top of the literature. I became very well versed in clinical reasoning pertaining to lower extremity injuries, post-surgical care especially involving the shoulder and knee, and develop a refined understanding of exercise prescription and weight lifting modifications for the injured athlete.

You spent 8 years in NYC at the Nicholas Institute of Sports Medicine and Athletic Trauma as a PT and researcher. How did this shape you as a clinician? Also, how did those 8 years shape you as a future business owner?

Having the opportunity to work at NISMAT was incredible for a number of reasons. First off, NISMAT was the first hospital based sports medicine facility in the country so it has a rich history. I also had the privilege to spend time with Dr. Nicholas Sr. (“Big Nich” as we used to call him). He was considered to be one of the original founding fathers of sports medicine and was a wealth of information. He had such a presence. I vividly remember him storming around Lenox Hill Hospital sporting his ring from the time when the Jets won the Super Bowl in which Broadway Joe Namath guaranteed the victory. He used to always remind me that “the research did not start when I was born,” and “everything in medical research comes with a date.”

Additionally, I also had the chance to interact and shadow several world-class surgeons starting with his son Dr. Stephen Nicholas, who was a pioneer in shoulder arthroscopy. I also developed a close professional relationship with the other surgeons in his practice. One particular surgeon, who I learned a great deal from was his partner, Dr. David Matusz, who is an exceptional spinal surgeon. Spending time amongst such high caliber and brilliant docs, demanded nothing shy of excellence from a rehab and communication standpoint. I was essentially their eyes and ears and always maintained close communication with them regarding all of their patients. I used to always joke with them by saying, “My goal is to disrupt your operating schedule, and cost you money,” to which they replied, “Be my guest!”

One of the most unsung heroes of NISMAT, who I’d also like to highlight, is Dr. Malachy McHugh, who is the current Director of Research. Considering the relatively small number of clinicians and researchers, it’s quite remarkable how much research the Institute publishes. Mal McHugh is one of the primary reasons for the prolific nature of this group when it comes to pumping out research. If you search MP McHugh on Pubmed, Mal’s contribution to the medical profession will be obvious and jaw dropping. One of the therapists, who also shaped me, was Tim Tyler, who is the current President of the Sports Section of the APTA. Tim had a wealth of experience and was not afraid to challenge me on every possible front irrespective of whether or not he agreed with my statements. As much as Tim used to piss me off, I realize in hindsight that it was ultimately for my benefit.

Any group would benefit modeling their professional endeavors after NISMAT, especially with their core curriculum. The core curriculum took place every Tues over lunch and involved a presentation by one of the staff members followed by a journal club pertaining to the topic just discussed.  The usual cronies sitting around the table were Dr. McHugh, the attending physicians connected with NISMAT, Karl Orishimo (biomechanist), Ian Kremenic (electrical engineer), Beth Glace (nutritionist), Tim Tyler (PT), Michael Mullaney (PT), Carmen Cheng (Managing Therapist) as well as the Sports Fellows and residents. Needless to say, we got into some pretty amazing and sometimes heated discussions and were always at the forefront of the research.

My time at NISMAT also shaped me as a future business owner though not in the way that one might think. Considering the high profile nature of several of the patients seeking our services, it forced to me to become very clear and calculated in my communication while mastering the art of motivational interviewing to elicit behavior change. It also forced me to appreciate my self worth because many of these individuals would seek me out for their rehab, which was flattering. It was always amazing to get calls from people all over the world, who would always make it a point to connect with me in the event that they found themselves in NYC doing business. I see far too many physical therapists undervalue their professional services and nothing upsets me more with regards to our profession.

What were some of the biggest hurdles you had to overcome when you opened your clinic, Chris Johnson PT, in 2010? What did you do to overcome these hurdles?

There are always going to be hurdles anytime one decides to “take the plunge” and start a business. My biggest hurdle, aside from the expensive nature of NYC, was opting to go into a space that was a bit further removed from Lenox Hill Hospital as far as Manhattan goes. This proved to be a deterrent for some though the patients, who ultimately valued my care, always took the time to travel downtown and crosstown to see me. You have to understand that in NYC, if one has to travel outside of a five block radius then it’s out of the way (first world problems ). Although business was initially slower than I would’ve liked, I took this time to develop my online presence.

After reading Gary Vaynerchuk’s book (who is also a friend/acquaintance), Crush It, it became abundantly clear that if one does not have an online presence in this day in age, they are creating a strike against themselves. Additionally, having spent the last eight years at NISMAT, without having much on an online presence, I was finally in a position to start taking everything I learned (right or wrong) and put it out there for the online community when I started my initial website/blog on Tumblr. Initially this was essentially a professional diary for me, though it soon became readily apparent that it was an amazing marketing tool and resource for people as well. Once I started getting positive feedback, I became that much more motivated to constantly write and would sit on the trains of Manhattan cranking out post after post.

Over the course of 12-16 months, I was in a physical therapist’s dream situation. I was operating a cash-based facility without doing any formal marketing while relying on no referral sources outside of patients sharing their positive experiences about working with me. I also always made sure to set aside a three hour window in the middle of the day to either train, write or shoot videos, which was an amazing way to break up my day. The only problem that I encountered, however, was that it was tough to grow a practice of this nature since no one wanted to work with anyone outside of myself. It also did not help that I named the facility after myself. In light of this information, I would therefore discourage anyone who is looking to set up and grow their facility to name it after themselves.

Staying in the universe of Physical Therapy, what important truth do very few people agree with you on?

Hands down the slow motion marching drills and isometrics (particular the ones featured in the “isometric training essentials” vid). The bottom line is that most folks simply do not have the patience to perform these drills as they are challenging, expose weaknesses, and do not make you sweat. Of the athletes I work with and coach, however, the ones who take the time to master these drills under various conditions become incredibly strong, robust athletes while improving their economy of motion. The reason I put such a huge emphasis on the marching drills is that they demand tolerance to unilateral loading while ensuring the performer can also fully weight bear through the affected extremity while assuming a balanced, upright posture. They also rely on no equipment and therefore are very practical even when folks are traveling. By slowing them down, they also demand a certain level of control and invariably demand the performer to audit the movement.

I should mention, however that once an individual masters the slow motion marching that I will increase the load through either using a weighted vest or performing them to a metronome at faster beat frequencies. As far as the upper body holds/isometrics go, they are a great way to introduce load to people. I’ve been giving isometrics for the past decade and everyone used to tell me that they were not “functional.” However, they also have a pain amelioration effect and are particularly effective in addressing tendinopathies. Cook, Naugle, and several other authors have recently highlighted the importance of training in this manner.

How did you end up with a writing gig for Ironman?

The power of social media! I simply messaged someone on twitter, who was connected with Lava, informing him of my desire to write pieces for their online publication. Within a matter of days, I had my first writing gig. Lava and Ironman eventually became two separate online publications, so I ended up sticking with the woman I had initially established communication with when she headed to Ironman full time. Writing for Ironman was very helpful for gaining even more traction online, especially with the international community, and I’m very grateful for this opportunity. I have not been writing for Ironman much as of late because my pieces are a bit technical in nature and inconsistent with their needs. This may be a bit surprising considering how technically minded and data driven most triathletes are. At day’s end I’m very grateful for having the opportunity to write for Ironman as they have built an incredible brand and still put on the best races in terms of reliability while ensuring a painfully awesome experience.

Who are your heroes? And, what is it that you admire most in them?

One of my heroes who is no longer with us was Scott Mackler (Lynn’s husband), who passed after fighting ALS for several years. He was the epitome of grit and determination. Even when he had lost nearly all of his motor abilities, he still was running a research team at University of Pennsylvania while maintaining a sense of humor. Anytime I feel like life is difficult and things aren’t going my way, I think about the challenges and hardship that he endured and I am quickly brought back to reality.

Read Part 2!

Be sure to connect with Chris on twitter: @ChrisJohnsonPT

Find Me: @Cinema_Air