October 10 2024
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Welcome to the True Sports Physical Therapy Podcast with your host, Dr. Yoni Rosenblatt. In this episode, we feature Dr. Charlotte Haggerty in an insightful discussion on how to become a great sport PT quickly. Dr. Haggerty shares her journey offering practical tips and advice for new and aspiring physical therapists looking to excel in sports PT.From building clinical skills to managing athletes recovery, Dr. Haggerty dives into what it takes to fast track your success in the field. Whether you're just starting out or looking to improve, this episode is packed with actionable strategies. Let's jump right in. Welcome back to the True Sports Physical Therapy Podcast.Dr. Charlotte Haggerty. This is a special moment in my career to be able to interview a sports physical therapist that was once my patient, that once. Looked me in the eye and said, I am dying to be a nurse. Was it a nurse or a pa? I know it definitely wasn't a pt. No, it wasn't. It was between PA and nurse.PA Nurse. Okay. Mm-Hmm. . And as soon as you said that, I thought you were absolutely in sync. 'cause I knew you would be a great physical therapist and you're four and a half months into your career. Thank God. It's with true sports. And I was right every once in a while. Um, a blind squirrel gets the nut and I was right about this.You are an outstanding physical therapist. So what I want you to tell the millions of sports PTs that are listening to this podcast is how you became so good. So fast. Oh, all right. So I would say a lot of it has to do with my background and just like. My background was sports. Um, so I played lacrosse in college at JMU, um, tore my ACL and that's how I ended up at True Sports rehabbing my ACL with Yoni and Jenny, which both awesome PTs.Um, I think going through the process and like being the patient helped a lot with like, resonating and relating to my patients, especially like those who are coming back from like a post op. Um, and then I also think my clinicals were great, but obviously best one was my last one at True Sports. Um, and Erica Breger, she was my CI and I, and Gina Hiskey.And I think the two of them helped me so much, just like refine my skill and like, kind of challenge me and push me and be like, okay, you've done this before. Like, what else can you do, um, to try to make me think outside the box of patients? Um, yeah, I think like those things kind of helped shape me to be ready to kind of take on like sports PT right after graduating.So thank you for the compliments. I appreciate it. Um, and obviously I agree with you on, uh, doctors Breger and Hiskey, but I knew you would be a great PT. Way before, um, you went all the way through your ACLs, right? Like we had that conversation probably really early on in your ACL rehab. I'm like, you would be an amazing PT.And I think it's because of your interpersonal skills. You didn't know crap clinically at that point, obviously. So what is it about your interpersonal skills that. You think allow you to relate to patients because it's not your, your patient being the patient, the patient process, I'm sure helps, but you relate to people unbelievably.That's why I'm super excited to have you on the pod. What do you do to relate to the patients in front of you today? Yeah, I think the biggest thing is just like listening and like actively listening and not just feeling like, Oh yeah, like I hear you, but like taking the time to like register and process what they say and be like.Kind of try, try to draw from experiences and like validate what they're feeling too. Um, I think that's a big thing that I've kind of learned. Um, it's just like being a good listener and trying to connect with them and not just be like, okay, it's another person. Okay, if I'm, if, yeah, that makes a lot of sense.If I'm your student, you're the CI, I'm the student PT. How are you going to teach me? To listen actively or actively listen. How are you going to teach me to be empathetic? What are some, some tools that I can work on to get better at that skill? Yeah. I think one thing, just like if I were to do this with a student is like challenge them to, you know, Take away like three, four, a couple things from like each session and be like, bring that into the next session.So like, if you are on a Friday and you're seeing them next week, ask them about their weekend, see what they're doing. And then on Monday, if you see them again, be like, Oh, how was that trip to your family? And like, bring that up. Because I think. Just that also they're like, Oh, this person like actually cares about me outside of just like being a patient.Um, and then it got just kind of like snowballs off where that, like that builds that trust and then they feel like they can come, come to you and kind of confide in you when things get harder. Yeah, that's really good advice. I think you can also do that clinically. It's interesting that. You know, you chose something that, um, like something they're doing on the weekend, something that is totally unrelated to what it is they're doing clinically.Um, and I think that builds the buy in that you're treating far more than just the injury or treating the entire person. Um, I think it also goes a long way when you can do that clinically. Like, Hey, I know your goal is to get back to X. This is why we're doing Y, um, that can really land with them. Where did you get your emotional intelligence from?Yeah, that's a good question. Um, I got a lot of them eggs. I'm sure you do. Um, I would say probably like my parents and just like my upbringing. Um, I don't know. I think they kind of built that with me, like kind of, I had two older sisters too. So like, I kind of had to figure it out earlier on with them. Um, and it was always just like, If something's going on or like you have a problem, like talk to someone or like my parents or my sisters about it and just like try, try to relate to people with that.I don't know if that was a good answer, but yeah. Um, I think it is a good answer. I think we get a ton from our parents. It's awesome that you had that support system. Also, you mentioned your siblings who also played high level lacrosse. Um, so like a part of your life. So, so I think that's a great answer.I think that's. That's super powerful. What, what, let's talk a little bit clinically coming out of graduate school. Where did you go to grad school? I went to Franklin Pierce University in New Hampshire. Okay. And so in Franklin, Franklin Pierce, not Franklin and Pierce, Franklin Pierce, Franklin Pierce. Yes.Um, who was Franklin Pierce? Should I know who that is? I think he was a president. Um, so Franklin Pierce are. What number president? No idea. Okay. Good. I'm glad you don't know that. Um, you did want me to know that that's president. Okay. So did they teach, first of all, did they teach you any of these soft skills?Um, I would, they taught it, but it wasn't really like, Not a lot of time was spent on it. There wasn't really any time where we were like practicing like these types of skills. They would mention it a lot. Um, but I wouldn't say we had like lab time or anything like sitting down and like doing this type of stuff.I think it's an, it's an important topic. I think it's like 90 percent of a patient's 14th president. Franklin Pierce, the, um, I love that it took a South African producer to let us know that that was the 14th president United States. Um, thank God we didn't have to take a citizenship test. So, okay. So, um, I think it's 90 percent of the patient's success is this relationship that you're building.Um, and it goes such a long way. So I love how intentional you are about it. Um, to really build, to build that camaraderie, to build that relationship. What do you do when The patient's a dud for lack of a better term. Like when you can't pull this information out of patients, how do you connect with them?Yeah. Um, that's definitely can be a challenge sometimes. Um, I think the biggest thing with like those types of patients is trying to find something that like makes them tick. So like. Even if they're like not giving into it, just like try to pry a little bit, like every time, not to be like annoying, but like bring different topics up.And then like, you'll bring something up and then you'll be like, Oh my gosh, like you talk, like you actually like enjoying yourself. So it's just like, don't be afraid to like, ask like random questions while you're doing, like going through your exercises and everything. Because once you find that one little, niche that they like, then you can just be like, build up on that every time.Yeah, it's crazy that you mentioned that. I know I've gotten to the point with patients when I could, I could not find that thing. And I've even gone as far to be like, Oh man, what does get you rolling? Like, what are you excited about? Um, and I think just like breaking the ice that way, being upfront, um, with that goes a long way.Okay. Back to clinical. Um, or clinically speaking, you come out of graduate school. Um, what patient presentation were you absolutely set up to succeed in? Like, man, I could do this with my eyes closed and what presentation keeps you up at night? Um, that's a great question. I think. Just based off of like especially my last clinical with you guys at true sports.I felt really good about like post op ACL having gone through it myself at true sports and then also like seeing so many ACL patients on my last clinical I was like, I feel good about this. Um Not so good. I would say And I saw a lot of them in the beginning where like low back injuries with lacrosse and like stress fractures.That was something I hadn't really seen a whole lot of. And initially I was like, Oh my gosh, like what the heck do I do? Um, and not knowing like how much I can push them and like, when I need to pump the brakes, um, it's gotten a lot better and I feel a lot more confident now. Um, so how do you do that? How, how, how do you get more comfortable?Yeah. So I think it's just like trying new things with different patients, but also I really like relied a lot on my boss, Sean Burr, great PT. Um, I asked him a ton of questions too. Um, and just like ask him like what he's found success in and that type of stuff. Um, and I think that helped me a lot cause I was able to tie in his stuff.And then based off of what he said, I was able to come up with ideas for myself. And then also. Look to the literature, even though there's not a whole lot with like, especially lacrosse athletes and stress fractures. Um, but yeah. Okay. So let's get into the weeds a little bit. So originally that was somewhat daunting.You didn't have an awesome background on that, um, both personally and, and also from your graduate school education. So you come out, um, what is your approach with these lacrosse low back pains or young, young adolescent athletes with low back pain? Yeah, I think the biggest thing was I tried to approach it in a similar way that I would if it was like someone else with low back pain, not be so like nervous about like, Oh, like, They had a stress fracture in their back, like, uh, um, and just like, what were you worried about?You were, you worried like, Hey, I'm gonna make this fracture worse and it's gonna, I think so. And like spinal column, I don't know. I was just like, this makes me nervous. And I was like, I don't want to do too much or like send them back. And they'd be like, Oh my God, my back is killing me. Um, No, I forget what the question.Well, well, yeah, but we'll get back to the question in a second. But just like around that I see a lot of apprehension from younger PTs on every pathology with looking through that lens. So they're like so worried that they're going to break something. I see it a ton with ACLs like I don't want to push too hard on this flexion or extension because I'm going to tear their graft which is so fragile and Just like going back to where, what that ACL has already been through in the OR, like it's already been putting in there.It's bolted in. The only way you're tearing this thing is if you have them pivot, if you have them cut really early on, you could slam it into extension and slam it into the flexion and, and everyone listening to this should kind of take solace in this. Remember before they get up from the OR table, their doctor is doing that.And that is the freshest. ACL that they're ever going to have, right? It's only going to mature from there. Although you get that little, um, setback at month three, but even, even still extension, flexion, you can push as hard as you want. Um, you got to worry about like tissue response, but you're not going to ruin the graph.It's the same thing with the low back, unless you're having them, um, do aggressive, I don't know, GHDs like past neutral or something like that. You're not going to make this fracture worse. You might piss it off a little bit, but. You're not going to break the thing. So I think you should take comfort in that to everyone listening to the original question was, um, your approach towards that spondy or the stress reaction, um, in the, in the low back, um, how it is now you approach that and what are some tricks that you have seen help get those patients over the hump?Yeah. Um, I think what I, instead of just like being nervous about it, I just kind of treated their impairments. Um, so like a lot of the times it was like their core. Was super weak. Their back extensors were like no endurance there. And then also their glutes were just like shot. So kind of taking an approach of like, kind of incorporating all three of those.So focusing on each one, but then also trying to find exercises that like kind of target all three at the same time. So making it more like complex movements rather than just like. Doing like back extensions or like a plank or something like that. So making it more like functional to their sport as well.First of all, I would add in hip extension, right? A lot of these athletes are missing hip extension. I just saw it in an outstanding 13 year old athlete yesterday. She's a high level point dancer, or she, she does points. Um, and she just lives in lumbar extension and is missing a whole bunch of hip extension, and you'll see that.Compensation pattern where they don't have the hip extension. So they steal it from their lumbar spine and then they're just slamming down on their facets. Um, so, so just like rounding out that picture, what are some of the complex, um, or the complex movements that you move them through to start with?Yeah, to start with, um, So I think like one of the most basic core exercises with like stability, I could do with like standing up could be like a Pavlov Pavlov press. And then you could add in some like rotation. So that would be like my basic movement to like start incorporating more like Complex movements.And then from there, like I've been really liking to do walking lunges with like med ball rotations, um, to get like moving with it. And then from there you can even start like adding in, like, if they're a lacrosse player, have them bring their stick in and like attaching a band to like the rack or a cable and then having it on the head of their stick and doing like full like rotation.So it's like getting like shoulder core and then also like driving through their hips. Yeah, I love that. And that's, that's so important for the lacrosse athlete. It also makes them feel really good to put a stick in their hands. Um, so, so I think there's a ton of value there. Another thing I've seen is working Working their core, um, to prevent extension of the lumbar spine.So not just to flex it, but allowing it to stabilize and prevent that hyperextension or falling into that lordosis can go a long way. Whether it be, um, like body stalls kind of end range, like that, that's, that's a very difficult exercise. Maybe starting with something like a dead bug, but putting the weight in their hands so that they have to resist that motion coming up overhead.Um, is, is certainly worthwhile. Talk to me about. First of all, let's go back to the Palof press, possibly my least favorite exercise. What do your athletes feel when you give them Palof presses? Uh, it depends on the athlete and like what variation I'm doing. I would say never am I giving them just like standing there and like pressing.Um, typically I'm doing like a split stance one if I do do it and then like adding in the rotation. Um, they, when I do give it, they're like, Oh, I feel it in my core. But sometimes like, Their form is terrible and they're just like flying all over the place. And I'm like, forget it. We're not doing this. Yeah.Yeah. Well, by the way, hags like that, that plays into your ability to relate to the patients and create buying the fact that you're willing to pivot from an exercise when the athlete doesn't find it. or feel it. Um, that's such a positive. Like I would put that on your list of why you relate so well. It's a self confidence in yourself, even though you've only been doing this for four and a half months, but also it lets the patient know that their response to a given exercise is going to dictate what happens next and that they actually matter in this rehab process.I think too often, especially with new grads, they come out of school and it's like, okay, low back pain, a dead bug. It doesn't matter what you feel, but this is what I read in a textbook that we should be doing. So good on you for that. Like, don't, don't breeze by that, Hags. That's amazing that you're doing that.And I think it goes a really long way to getting these, these patients better. So then once they're able to kind of move through that, let me ask you this. How, 14th president teach you to do? Around transverses abdominus like do you ever isolate that are you ever using those words when treating these patients?Um, not really. Um, I would say it was touched on quite a bit in school with like, all right, we're just going to do like posterior pelvic tilt and then like hold. I would say with like my lacrosse athletes or like even like higher level athletes that are coming in here, like That's too easy for them for like my patients who maybe have had like back pain for like years and years and are just like living in like a ton of lordosis.Finding that like neutral like pelvis and like activating transverse abdominus. I think that's like When I use that more, um, but like keeping that neutral spine with like a dead bug, that's like more when I do it, I'm not just ever like saying like, okay, let's lie on your back, bend your knees and let's rotate your pelvis.Yeah. Yeah. Um, or like the palpation, right? Like, Um, I know I was taught in grad school to like start on asis and move like an inch in an inch down and really try to feel that contraction. I've gone away from that because I think it's just too confusing to the patient. I just didn't know where Franklin Pierce and maybe other grad schools are with that.I also know like I was so heavily schooled on sacroiliac joint dysfunction as the end all be all of all things low back and I've gotten totally away from that. Personally. Um, I live far more in the facet compression spawn, the, like that world. I think that's more of a pain generator. Any thoughts on that?Like where SI comes into this? Um, yeah. So I feel like more recently in like my older population, I've been seeing more of like that S I J stuff, but with my younger. Population with like middle school, high school, or even like college, it's typically like all like the set related or like the spondees.It's, I feel like it's very rarely like coming from SIJ. Does it change what you do therapeutic exercise wise? Um, I would say not a whole lot. Cause typically it's like glutes. It's like what's causing like the SIJ stuff. Um, so I would say like, not really, cause it's typically like the same presentation.Overall, yeah, you're going to do, you're going to do the same thing. Like what man, when I was in school, it was like all about the SIJ understanding what the sacrum is doing. Is it new tating? Is it counter new tating? By the way, I don't know why we can't just say flexion extension, but as it pertains to the sacrum, it's nutation and counter notation.What are we palpating? How aligned are their PSI S's? And I'm so out on that. Um, I would love to. You know, do a podcast in five years from now, and maybe I'm like, Oh, it's all about nutation and counter notation. But at least where I am now, that's what I'm thinking through sports. Physical therapy is growing like wildfire.We've had 14 locations soon to be more. We are throughout the state of Maryland. We're in Pennsylvania, in Lebanon, in New York, Pennsylvania, as well as in Delaware, in Newark and Wilmington, Delaware. Like I said, so many more practices to come. And we always need. Outstanding sports, physical therapists. Our treatment style is unique.We are one on one with your athlete for 45 minutes, every single session, you do the entire treatment, you do the entire evaluation, and they are in state of the art facilities where you have room to run, throw, and jump, and really get your athlete all the way back to on the field and better and stronger than they were.We also have outstanding salaries. comp structures, bonus abilities, 401ks, as well as a very strong continuing education offering, including in house continuing education. And we're looking for you now is the time as we are growing like crazy. Just shoot your resume over to Yoni Y O N I at TrueSportsPT or shoot us a DM and we will hit you back.We will get you in for our unique Tried and true interview process and really make a determination that this is the right place for you to grow your career and get your athletes better than ever. We can't wait to hear from you. Let's let's talk. Um, well, along the spa in the world, you mentioned how important it is to strengthen Lumbar extensors.When, when, if ever, do you put those in, in isolation as a part of their program? Um, I would say it's definitely not one of like the first things I do with them, but we, like, I have been using, like, we have this back extensor machine, I guess. Um, um, so I would say like, once I feel like they have like a good sense of like, Neutral back and like their core is strong.That's when I'll like put them in there and do like back extension. And I'm not just having them like go back up and down, up and down. It's more like. a hold with like a plate and then we could add in some like rotation with that too. Um, but it's definitely not something I'm like, okay, second visit, let's go to the back center machine.Yeah, I think that's a couple things there. One, I think that's the most dangerous thing with a spondee because Um, if they don't have good abdominal bracing or control or under just understanding what's going on there, they're going to compress, compress, compress every single time. Um, I love that you're including rotation there because that shows up so much on the lacrosse field um to get them stronger and also remember like you can.Grade your way into that or progress them appropriately, right? You can do isometric holds there. You can get them to feel a lot of these athletes do not feel their paraspinals like, um, they equate that with pain or they'll get low back pain before they feel muscle fatigue and trying to tease that out.You know what helps with that? Your unbelievable relationship with the athlete. And then once you have built that trust, you can begin to explain that and educate them that it's okay that they feel their low back. Let's see what it looks like tomorrow. Um, and just getting them stronger there. Um, so I think that's, that's really awesome.What about, um, do you get these athletes to return to cutting and dodging in clinic? And when do you put that in? Yeah. So I actually have a patient right now. Um, who had a spondy, she's a basketball player. Um, and we're kind of progressing into that now, which is super exciting. Um, so I've been working with her probably since end of June, beginning of July, and we didn't really start doing any of that until maybe, maybe a month ago.Um, so like we were focusing. Very heavily on like core back extensors. And then her glutes, her left side was just like completely shot, like no strength in like quad glute hammies, abductors, any of that. So once she was able to do like, I would give her like a couple of different things. So we did like rear foot, LV split squats, both sides.If she can do like same amount of sets and reps on both legs, then I'm like, okay, that's much better. Um, same thing with like glutes. We did like kickstand RDLs and then same type of deal with like core and like back extension. And what she was good with that, I was like, okay, let's start introducing like pre plyos, see how that goes.And we can be like, okay, let's try return to run program. See how that goes. So it's very like graded approach instead of being like, all right, today, we're going to try cutting for the first time. Yeah. Yeah. I love, I love that approach. Reminds me, I was just having a conversation with a patient. Um, who said one of his teammates tours ACL and leading up to that tear, he had terrible sciatica, um, along that same leg.And I think you're doing a great job of trying to understand what does the athlete need to do and what does the lumbar spine affect? It affects everything. Everything down the chain, right? So I think a lot of this is a great differentiator between PTs and sports PTs, like to understand what the pathology or what the athlete needs to do to get back on the field.Um, and then trying that in clinic and making sure they're good in clinic and, and developing an exercise program around that. Um, that's, that's really awesome. I PTs with discharge when they don't have low back pain. Um, so making sure they kind of All the way back there. Um, do you put them through testing?I know you mentioned the exercise they had to do. Um, so I, there wasn't necessarily like specific, like strength testing. We didn't do like 10 neck or anything like that. Um, it could have been a great thing to do. Um, but just based off like how she was moving, how she was feeling and just like how much we've been loading and how much she's been able to tolerate, I felt confident in like, Starting the plyos and all that type of stuff.Yeah. And, and Tindec would be awesome. Even like functional testing would be really interesting. I mean, you mentioned like, can she do RDLs? Can she do split squats evenly? Um, hop testing, hop testing for time would be interesting. Um, there's an interesting protocol out of the Stedman clinic post op, um, labral repairs where they, where they do.Is it a, I think a three minute single leg squat test with a band? It's crazy. I think it's terrible. I think it's three minutes. Um, and they count how many reps side to side. They wrap a band on the planted foot and hold it in the opposite arm. So it's working the hell out of your glutes and they have them just freaking squat for three minutes.And that's gotta be symmetrical before they move on. It's a great idea. It's just more of a functional test. If you don't have a Tindex, um, just a suggestion, by the way, Hags, I did not plan to talk spondees with you. It's awesome that, um, you have such a great grasp on what you got going on. So how do you, how do you keep up with that?You, we put you into a very busy clinic cause we knew your stud and you told us you wanted to freaking live in Bethesda or over there. Um, how did you, how do you keep up with all the notes, all the marketing you're coaching at Bethesda lacrosse club, shout out to them, um, on the side. How do you juggle all this?Yeah. Um, I think for me, it's like, I have all that stuff going on too, but I make sure I take time that's like away from all of that. That's like for me and like things that I enjoy, which makes it feel less busy and less chaotic at times. It can feel chaotic with everything going on. Um, Doing that and then also like prioritizing like what needs to get done.I think doing notes like in clinic, like trying to get stuff done while I'm with my patients, but not being like facing away from them, just like on my computer the whole time, just like adding in stuff as we go. I think that's helped. And then just like when I have any breaks, if I end up having a cancellation midday or something working on stuff then.Um, but I think the biggest thing for me is like still like finding time for me to decompress so I can still do all those things that like my hundred percent. Yeah. Yeah. What about on the, on the research side or keeping up to date with literature? How do you go about that? Yeah. So I, this has been something that Sean and I have been kind of talking about a good amount.He has been sending some really awesome articles just like about like random stuff if he finds anything. Um, and then also I kind of go, if like, I'm like, I need some more information on this or I'm like, I'm not, I don't know this that well. Um, I go right to like Google and like, look for like, well respected things.I'm not like first thing, let's see what they say. So it's always like articles. It's never just like a, a website. Um, I use APTA sometimes too, for like CPGs. Um, I feel like that can be helpful. I feel like you can also kind of like rabbit hole yourself with a CPG. Um, but it's good, just like a guideline or baseline.Yeah, that's really awesome. And shout out to Sean for doing that. That's really, that's really great. Talk to me about your onboarding process. Um, how much mentorship is there for you? Yeah, um, it was great. I mean, I think I was really lucky and I'm sure this would be at any clinic at true sports, but with Sean, he was like any question you have ask it.Um, and he was just there whenever I needed anything. Um, so I think that helped a lot. I think it's also, we have so many amazing PTs. All of them are amazing at true sports. So like. Not feeling like nervous to like ask other people for things too. Um, cause I feel like everyone just like wants you to get better.So asking as many questions and like, we had set days where like, okay, this time, this monthly meeting, we're going to go over this, but then we're also going to go over like 10 deck of the hip or like return to pitching or anything like that. Um, so I think that was really helpful. Yeah, that's great. And if you're in a smaller clinic, I would encourage you, anyone out there who's listening, like, don't be afraid to go back to your professors.Don't be afraid to lean on your classmates, your former classmates, because sometimes you can take a job and it's just you and maybe one other therapist, something like that. Um, but you got it. You got to find people that have had so many reps, um, to do that. Like, I, I just left the clinic around the corner here, but One of the therapists said like, Hey, can you look at this elbow?I've know you, I know you've seen like a million throwers and you want people who are on your team. Like I get excited to do that stuff and any, any mentor would. Um, and then if you've been out for a little while, I would say the same thing. Like Tim stone is awesome at this. Sean is awesome at this.Sean's been treating for five, six, seven years, something like that. Um, he's a great therapist. I walk into Bethesda clinic, he's asking me, um, about a presentation or something like that. So, so always ask, and then you make a great point. Uh, now there's so much information out there, but being discerning in what it is, your, you're going to take to your patient is, is super imperative.So what is it that when you say respected journals or articles, what criteria are you looking for? Yeah, so like, if I'm looking at an article, typically, like, I would like to really like a systematic review or like a randomized controlled trial, like, those are my favorite because they're also like, The most controlled, especially like an RCT.Um, I try to stay a little bit more away from like case studies and that type of stuff, cause they don't like literature, they're just like, not as well respected cause it's like, Oh, this is with one person. Um, so I feel like looking for like RCTs or like a systematic review is kind of like, I try to lean into those two more than like, The, like a case or cohort case study or anything like that.Yeah. Um, you also make mention of the way you try to manage your time, right? You try to get a lot of things done when you have little openings, even if it's a sentence or two, you're able to complete a note. Um, that sounds like a lesson that you may have picked up. Um, by being a national champion and being on, um, a crazy schedule that is a division one athlete schedule.What else did you learn from those experiences? Both championship and just being, uh, an elite athlete and a student. Yeah, I think obviously like what you talked about there, like time management. You can't use that one. No. Well, I was gonna give you another one. I would say like, uh, teamwork Is a big one.And like confidence. Um, I think as a new grad, it can be hard sometimes to like, feel confident in like what you're doing. Um, but you've gone to school for four years, undergrad, plus three years of grad school. Like, you know, Your information, you just have to like, trust your knowledge and apply, but then also know and understand when you don't know something.And like, Be okay with that and like secure and what you don't know because you just started and like look for the answers. Um, I would say that and then with teamwork just like being open and like excited to collaborate like what you talked about like with other PTs. I think that would be the two, two of the biggest things for sure.The questions I used to dread as a new grad were how long is this going to take? Um, like when am I going to feel better and how long have you been doing this? How do you handle those? Yeah. Um, I think it's gotten a lot better. The first couple of times I was asked, I was like, well, I'm not really sure. Um, but I think as long as you're like direct with them, be like, typically it takes like this amount of time, but it can be shorter.It can be, uh, longer than that. I think it just, and also kind of reiterating, like it was, it's It's also going to be like how much you're putting in. So kind of like putting it on me, but also like putting it on them too. And like, if you're in here twice a week and you're only doing PT exercise, it's twice a week.You're not going to see results in six weeks. It's going to take a lot longer than that. But like, if you're in here twice a week, then doing your exercises, like three times a week outside of here, you're going to see results a lot faster than someone who's just like coming in and doing their exercises and not doing them yet.Yeah, that is an awesome answer because. It's going to build buy in and that's what we're dying for. First of all, it's going to give you another visit and, and you always got to make that a goal with a given session. You want to, you want to understand what's going to make this patient come back. I know they're going to get better if I see them more.Um, how can I get them to come back? That's one great way to do it. How do you handle, how long have you been doing it? Because if you say two weeks, you're going to look like a schmuck. Yeah. Um, yeah, I would say like my first couple of weeks was definitely. a challenge with that. But I think I also, I'm like, yeah, this is my, if, when it was my first week, I'm like, yeah, this is my first week.Um, but I, I did my last clinical at true sports. I was there for about three months. So I'd been with the company for three months. I was also a patient. So like kind of adding that in, I feel like even just saying that I was With the company or just like in doing clinicals, they're like, Oh, like that makes me feel better that I'm not like the first person they're ever seeing.Yeah. Yeah. I think that goes a long way. Um, another thing you can do, I think that's a great answer. Uh, another thing you can do to, to our audience is, um, be super, uh, upfront about it, like my, my answer eventually became, they would say like, how long have you been doing this? I'll be like, uh, counting today.I've been doing it for this long, but like, but as long as they understand that, you know, where you are in your journey, you know, that you need to make sure you're keeping up with all the lit review and everything you just mentioned this teamwork, I think it just gives them a sense of security. Cause remember, it's not just you treating the patient.It's the entire clinic treating the patient. It's the knowledge base of the company. It's the knowledge base of your doctorate degree. Like I just got out of my doctorate program. Sounds a lot better than, um, I've been here for a week. Right. Um, and so, and, and you have to internalize that. Like I think new grads and I, and we have, I have this conversation all the time because I see new grads, not you present company excluded struggle with stickiness of a patient.And I think that happens because they're wishy washy on their diagnosis. They're wishy washy on what it's going to take to get the patient from point A to point B. They don't challenge the patient enough because they're scared they're going to tear the kid's ACL. I'm not saying have them cut on day one, but I am saying you have to get to a point in a given session where you are achieving some type of milestone or some type of goal, even if it's, you're going to wake up your quad that day.Like the patient has to feel some type of success that they're making headway. Otherwise, why the hell are they going to come back? Um, and I think that. You know, that can, that can breed that stickiness that, that can be a challenge. How do you figure out how hard to push your patients in session? Yeah, so it's a like on eval day, I'm not going to like initial exercises that I'm giving them to do at home are typically pretty basic.Um, and then I'll always have them like, Oh, the next day they come in, I'll be like, Oh, did you have a chance to try those exercises at home? Um, just to see how those what, um, and then from there, I try to, it's, well, I try warm up with something basic, see how they're feeling. And then from there, it's like, okay, we're going to try this today.And it's going to be like, each time I try to like build up on what we did before. And if something was a challenge the last time I'll be like, okay, let's do this again. And be like, okay, last time you were only able to do it for this. Today you're able to do it for this much longer, which I think also builds a lot of like buy in with the patients too.Amazingly. So it also speaks to your active listening spiel at the beginning. Like you, in order to do that, in order to reference what they did last session, you have to be totally present in their given session, watch how they do it. Maybe document it. Definitely not my strong point, but, but remember how well they did last time.So you can. Call it back and reference and show them progress because they're going to forget. Um, so I, I think that's an awesome way to go about it. I also think it's so important that the sports PT. If they don't challenge them, like in your eval scenario, you tell them what's coming. I know this is easy.I know these are basics. We're going to kick your ass next time, or we're going to progress it next time. Um, just to tell them to, to make sure that it's engaged. I see patients falling off from new grads. When, when they're not pushed, um, I think that's, that's a big reason you guys quick pause and a quick shout out to this new masterclass that we just launched here at true sports physiotherapy, myself and Dr.Tim Stone put together a masterclass of ACL rehab, and we call it from table to to turf and the reason we call it that is because it's going to teach you exactly how to get your athlete all the way from post stop day one with the nitty gritty of regaining all of that range of motion with the tips and the tricks that we use here at True Sports Physiotherapy that gets our athletes better faster and stronger and that's early and then how do you progress that athlete all the way onto the field with a ball in their foot or stick in their hand or whatever their sport is and teach them.How to accelerate, how to decel, how to change direction, all the mechanics that go in there. What drills do we use to get our athletes exactly where they need to be back on the field and even better than before injury. And I want you to sign up for that class. Now you can find it on our website. You can shoot us a direct.Message and just say, Hey, send me the course it's right now on sale. So make sure you sign up now. It is fully accredited to get you all of your continuing education hours, sign up for the true sports masterclass ACL from table to turf. Thanks guys. Um, okay. Give me man, you paint an amazing picture of what it's like to be a rookie PT.Give me the biggest mistake you've made so far. Clinically. Oh, this is a good question. Man, biggest mistake. Um,while you think about it, eggs, here we go. Here was mine. My second week of being a grown up physical therapist, my boss went on a Goddamn golfing trip, probably, and totally left, like, me in charge of the clinic like a moron. He calls me from the, from the golf course, and he's like, Hey, uh, my best friend just hurt his neck.He's coming in to see you next. I need you to take good care of him. The guy comes in in a collar. Like, can't move his neck. And what do I do? I'm like, well, I, I know what I'm doing. I research his scrap. I give him chin tucks. Literally, he left in tears. He lit a grown man crying. I was 26 at the time and I was totally frozen.I clearly haven't gotten over that. That was a massive mistake. I should not have given him chin talks. I should have understood. I don't know, just giving him something to feel better. Um, I totally crapped a bet on that. Now you go, Hanks. Okay. I would say this was with, um, it was an eval day as well. This was, uh, I had a patient, she was coming in with knee pain and I was like, Oh, this is going to be great.Um, from like, and heard that like, things were not going to go as I planned. Um, well, she came in with crutches. She was, it was during summertime. So it was crazy, crazy central and Bethesda with basketball camp going on. Um, so it was super loud. Um, she was, she came in, she was making comments about the noise, rightfully.So it was crazy. Um, and then like this patient was in her late sixties, early seventies. It's had pain a ton. And I was like, all right, like. Let's get into it. Did all like range of motion, strength, all that stuff. And I was like, all right, let's get out into the gym. Like, let's start squatting. Let's see how you're moving.And like, I think that was a time where I was like, I am not reading the room and like reading my patient right now. I'm not actively listening. I'm just like, okay, I need to check all these boxes and get all of these tests and measures done to like, do my eval well, instead of just being like, okay, like.Should have just listened because then it just wasn't a good situation and I don't think the vine really Did you like, did you, did you get a second visit out of that? I, so I got one other visit and then she went to ocean city and she was supposed to come back and she's like, it's not the right fit for me.Like, fair enough. You're like, I agree. Okay. So we'll play it out again. What, what would you have done differently? What'd you learn? Um, I learned to just like, even if it's an initial eval day and it's like the first time you're meeting the patient. You don't have to hit every single box on an email. Like if something's not going well, or like a patient's not responding or just like in a ton of pain, you don't have to hit it day one just to like get all the boxes checked.And I think that's what I was so focused on was like, I need to do this and this and this for insurance, blah, blah, blah. But just like you can come back to that another day and just like educate more, talk to them more, build that buy in rather than being like, Okay. So that hurt. All right, we're going to do the next thing and this might hurt even more.Um, so I would say if I could do it again, just like not do that and just like listen and like try to educate and like explain more rather than just like do. Yeah, it's, it's so hard to know that as a new grad, like that's probably a great opportunity to, to skip, I don't know, the straight leg raise or the end range hip measurement or whatever.And maybe even, I hate saying this, but maybe even the right thing to do. There is soft tissue massage or like something to just kind of connect with the patient, maybe bring down their symptoms, even if it's short term, which is painful for me to say, because, um, it, it is, it's just painful for me to say, but that probably would have been great.So, um, good for you for like learning that lesson. Um, what's, what's one where you surprised yourself where you crushed it? Um, let's see. I would say this was like tough. I, it like was tough in the beginning. And then I was, I surprised myself by it. So I have a patient he's in his thirties. He had an ACL reconstruction a while when I saw him, it was probably like three months.He was three months post op. Um, he didn't have a heel pop. His quad wasn't activating. His flexion was terrible. And I had never felt like what it. Felt like to have like scar tissue build up in the knee. And we were working on like flexion every time. And I was like, something's not right here. So I emailed his doctor and like, had talked to the patient and was like, something's not right.Like we're making no progress. Like. I think he should come in and see you and get an MRI and like doing that as a new grad and not knowing like granted I'd talked to like Sean and like the other PTs at the clinic at the time and was like what do you think like do you like I'm thinking it's it could be like a Cyclops lesion or like scar tissue like.What do you think? And just like having them kind of support my thought process. Cause I hadn't really seen it before. I've never seen it. And then being confident to be like, okay, email the doctor, talk to them and then push to get like an MRI. Turns out it was a Cyclops lesion. He had like a MNIP and now he's doing so much better.How did our interview process not prep you for that or make you feel confident in that? No. Yeah. That case, right? Um, that's awesome. I think that's so difficult. I think it's so difficult as a new grad to be like, ah, let's push the panic button and call the doc. Um, it's rarely a mistake to outside of the ego.It's, it's rarely a mistake too. So, um, I think there, there are awesome lessons there. Um, okay. Hags, you make this easy, man. I'm ready for our lightning round. Yes. Let's do it. Okay, here we go. Your so quick answers, please. Okay, quick answers. Got it. Your favorite lacrosse memory and you can't say winning the national championship.Obviously, that would have been my number one. Okay, I would say beating UNC my freshman year. Our first game of the year. Because? Because it was, we won in double overtime. Amazing. And, like, it was my first college game ever. And, like, I was playing in it, NBA, UNC, and I was just like, this is a great way to start the career.Were they wearing their whites or their blues? Their blues. It was an at home game at JMU. That's, that's tough to beat them in their blues. I know. Yeah, it was a great game. Okay. Did you score? No. Okay. No scoring. I had, I had some calls turnovers. Okay. What position? I was a mini. Okay. Uh, yeah. Still could have scored.I still could have scored, but I, um, okay. What is, what does your workout look like? Um, right now it's heavy on the running. So I'm training for the Baltimore half. So I'm running a lot. When the hell do you do that? Um, in the mornings. Yeah. And you do that without any anterior knee pain? No pain on the right.My left is giving me some pain now, which is a shame. Okay. For the record, I only treated the right, correct? Yes. Okay. The right side is doing great. Okay. That's good. I would say like, I would put you on my list of. Clinically speaking things I would do differently. I bet you I would do a better job. I would hope I would do a better job of avoiding anterior knee pain because I know that was like a big issue you and I had.Um, I'll take the blame for that. So sorry about not killing you with knees over toes. Sorry for not loading your patellar tendon properly early on. Um, I'll do better now. That's all. Okay. Yeah, that's all you work in true sports. That's that's all. Exactly. Um, okay. If you were not a physical therapist, Charlotte Haggerty would do what for a living, man.I would say I'd either be a PA or work in medical device sales. Okay. Why would you want to be a PA? Cause I love healthcare, not healthcare. I love like being in like the healthcare scene and like helping people like, and nurse is not it for me. I'm glad I didn't go. Okay. What about, uh, why not a physician?Um, I just truthfully the schooling I was like, you know, I don't really see myself doing that. And then with a PA, I feel like you're able to have more of a life, like a, you can have more of a life outside of your job, which is super important to me. Yeah, I will say when I mean, you have tremendous earning power as a PA.You can make a good bit of money and it's only two years of school. Your awesome emotional intelligence would not be as visible if you were a PA. I think you just get shorter amounts of times. Um, I'm so happy. I twisted your knee into becoming a PA. I know, me too. Um, okay. What about, um, reading? Are you a big reader?Um, I have gotten into reading over the summer. I was reading a lot. More recently, I have not been reading as much. What were you reading over the summer? Trash book. Really? Yeah. I like got into this one series that I like love, but it's like, it's nothing like educational. It's like, I like to turn my brain off and just like, Disappear into other things.Why? So, I can respect that, from a standpoint of turning your brain off, but why read instead of watch? Um, well, it helped me sleep better, is one. Like, I would do it before bed and every time I would read it, I would be like, oh, I have a great night's sleep. Um, And then also, I feel like it just, like, was still, like, simulating my mind without just, like, aimlessly or endlessly scrolling and just, like, watching stuff that didn't even matter.I feel like the more I'm, like, scrolling through my phone, I just feel like after, like, an hour, if I do it, I'm like, My brain it doesn't work anymore. You're scrolling for an hour. No, no, no I'm saying if I was scrolling for an hour instead of reading Yeah, but and what's your Netflix game? Um, I just finished nobody wants this Are you just saying that cuz I'm Jewish?No, okay, so a ton of my patients Recommended it. And I was like, got to watch it. And it's great. Everyone is telling me to watch that thing. You've got to. And everyone says, watch it with your wife. Yeah. It's short episodes. You like, it's not like you're sitting down for an hour. It's like 25 minutes. You can do that.And it's funny. Yeah, it's good. I like laughed out loud sometimes. Am I going to like the way the Jewish guy is portrayed? Where is he like annoying as hell? No, he's not. He's a rabbi, actually. Okay. My question still stands possibly even stronger. How is he portrayed? He's not annoying. He's like, he's a cool, he's a cool guy.Okay. So, so you found time to watch it. Have you watched, um, Uh, Mr. McMahon on the rest. It's, it's about wrestling, uh, in the documentary on it. I highly recommend that, but I used to be a wrestling nerd like 30 years ago. Um, enough about me. Um, hags having you on, you've done an awesome job of kind of highlighting how to get better at what it is we do for a living.Your growth mindset is amazing. Unbelievable. Your ability to connect comes across, even though this is being done virtually. So keep it up. Hags I'm, I'm excited. I was so on the money with the fact that you would be an awesome PT and, and congratulations to you for doing the work to, to become a great PT.Um, yeah. And thanks for spending some time with our audience as always to all you guys listening, let us know how we did. You can DM Charlotte Haggerty. How? Um, you can go to my Instagram, it is, let me, let me pull up the name, it's new, so, yeah. You can, let's see, what is it? It's chagrity underscore dpt.Graham, I love that. And we'll be seeing outstanding rehab content on that clearly. Um, but let Hagerty know how she did. Let me know how I did true sports PT on Instagram. Um, you can shoot Charlotte and email Charlotte at true sports PT. com. I believe you can always email me Yoni Y O N I at true sports PT guys.Thanks for listening. Dr. Hagerty. Thanks for being awesome. Appreciate your time. Thank you so much for having me. It's been so fun. No problem. Thank you. Bye bye. Bye bye.
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