August 28 2024
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Welcome to the True Sports Physical Therapy Podcast with your host, Dr. Yoni Rosenblatt. Today, we explore the exciting world of virtual physical therapy with Dr. Reagan Langlias. In this episode, we dive into the steps, strategies, and challenges of launching and managing a successful online practice. Join us as Dr. Langliers shares her journey into the virtual PT space, offering practical advice on everything from setting up your practice, attracting clients, and providing top notch care remotely. Whether you're a physical therapist considering a move to virtual practice, or looking to enhance your current setup, this episode is packed with insights that can help you thrive in the digital landscape.Hey guys, welcome back to the True Sports Physical Therapy Podcast. Today I had a great conversation with Regan Langliers. Regan's super interesting because she started her own business directly out of graduate school, and she started a virtual PT practice. She treats athletes from all over the country, and she does it virtually.We're going to get into exactly Why she started it, how she runs it and what her vision is. She has some really awesome tips. If you're considering anything like this, I would listen closely to this podcast because she's going to talk about some of the mistakes she's made. But also she has a great outlook on how she kind of revamped and restarted her business.And now it's really primed to grow. We get into some. harebrained ideas as to how to grow it even better. Um, some low hanging fruit and some opportunities she may have. And she told me a lot about entrepreneurship. So I hope you guys learn a lot too. Her business is called athlete rx. com. It's spelled a T H E L I T E rx.com. Look her up. She's got a great story. She was a pleasure to talk to. I can't wait to hear feedback from you guys as always. Shoot me a DM, TrueSportsPT on Instagram. Let me know how we did. Let me know if you want to be a student at TrueSports. We'd love to have you. Let me know if you want to take our ACL course that we just launched.We also have an overhead athlete course that we have coming out. Would love to talk to you about that. Always open to chat. Always open to feedback. TrueSportsPT on Instagram. Can't wait to hear from you guys. And now, without further ado, here's Dr. Reagan Langlairs. Welcome to the True Sports Physical Therapy Podcast.Doctor Reagan Langley is with us today. I'm thrilled to have you on because I've been chasing you like crazy to get on to this podcast. So, thank you so much for making time to join us. I know you're super busy. No, thank you so much for having me. I'm glad we got to find a time to sit down and chat. Hell yeah.Now tell me what you're so busy with. Tell everyone listening what you're so busy with. Well, you know, I kind of have a odd schedule, so I married a professional baseball player, so he's pretty busy. playing all over the country. So that's kind of why I started my business, um, being virtual so I can, you know, stay with him, kind of travel a little bit, um, work from wherever works for us.So that kind of has my schedule just a little bit more hectic than it normally would be, but yeah, that's okay. So, so first of all, I'm a baseball geek. So tell me who he's playing for. He plays for the Oakland A's. So we're out in California right now. And what level? Um, major leagues. Hell yeah. Yep. Um, that's what I'm talking about.Yeah, so he's still, still a younger guy, but yeah, we're having fun. Okay, you said this is his what year in the bigs? This is his second full season. So he got called up in August of 22. Okay. And how long you been with your husband? We've been together since college. So, I think that was 2017, 2018. Um, yep. So, made it through PT school, minor leagues, all of the stuff.So, yep. That's amazing. Well, congrats to, congrats to you guys. Congrats to him for making the show. Um, this is not where I wanted to take the conversation. We'll come back to Reagan Langley is for sure. But, um, tell me what it's like from, from like the rehab perspective, watching your husband go through the minors.Um, and then to make the show, what was the rehab and strengthening conditioning like? As he went through this process. Yeah. So it's really interesting for him. I feel like the minors to the bigs, it's very different. It's a little more structured. You kind of, um, you know, you kind of have to do what you're told then, but now it's, it's very much more individualized.So like he has his own schedule, like he does his own stuff. Like he's a catcher. So knees, obviously big deal. So catcher catcher, they even have different things that they do. So it's just very much so more individualized, um, which has Um, influence how I treat as well, because again, it shows me that, you know, everyone's rehab, like it should not be a good cutter, um, it needs to be very specific, very individualized, um, to the person.Okay, but tell me about the crap show that is the minors and how terrible the rehab and life in the minors, because it's crazy. I work with a bunch of big leaders, one great one, a guy named Ryan LaVarnway, who's like a hero of mine. So he spent forever in the minors finally cracked in with the show and lasted like 10 years.And, um, in the bigs, and he had a great analogy. He said, it's like going from janitor to CEO, like overnight. Right. Right? Like all of a sudden you have money and you're at the Ritz and you're on private planes. But before that, you're literally losing money. Like I work with the guy in the White Sox organization.He said in double a, he spent more than he made while playing double a baseball. So he just lost money and he's still close to the show. So what is strength and conditioning rehab recovery? What's it like in the minors? And then how did you help your boy get all the way to the show? So, I mean, it's crazy.The lifestyle is crazy in general. I mean, You know, on buses and they're driving hours for games and it's just like recovery, you're already kind of like in a pit to start because you're not really getting much sleep and, you know, you might not be eating the best of food. You kind of eat whatever's there.So just like all the lifestyle factors are already kind of against you. Um, so. I felt like for him, he had to take it into his own hands. You know, it's kind of like you, if you need something, you have to like, kind of make it happen. Whereas it's just like a silver platter when you're in the show. Um, you know, like they want to help you there.They're like, obviously, like, I mean, obviously they want you to be healthy in the minors, but you know, it's just on a bigger, on a bigger level. So, I mean, really just keeping him consistent was kind of what I felt my job was, um, like kind of encouraging him, like, Hey, like, you know, It's gotta be like, you have to like be in charge.Like no one's gonna advocate for you, um, if you really need something, um, just going through the minors. So yeah, just really saying like, Hey, I need this, this is what I need. Or going and looking for it on your own. Um, if the resource, yeah. So what were, what were some, because there are no resources, so what were.What were some of the golden nuggets that you shared with him as a medical professional while he's kind of on his own? Because I think that relates really closely to what you do now, where, where you'll get people from all over the country, setting up appointments with you to do virtual PT, and you got to make do with what they have in their bedroom or in their gym or whatever.So how do you approach that with him in the minors?Um, yeah, really limited. So really keeping it as simple as possible, like what works for you? Like he learned that like more is not more for him. Like he's very, a minimalistic guy, even when it comes to like, um, like his maintenance work and stuff like that. So just finding really what works for you. Um, You know, he would get to the field early.He'd hop on a bike, just like warming up, like keep keeping things simple, warming up really good. Um, like having his, I just feel like consistency was his biggest thing, like picking three like modalities, even if it was, you know, just the foam roll, even though I don't always, I'm always like, don't want to try on the foam roll, but he loves it.So like mentally for him, like that might be something that, you know, fine. Like sit on, like sit on the foam roller for 10 minutes, like do your thing. Um, Because it's a lot of baseball, it's a lot of games, so just whatever can get you mentally right, um, and whatever feels good on your body. Sometimes it's just, for him, it was just about like just making himself feel good because he has like a very physically demanding position.Um, so yeah, just staying consistent, keeping it simple, doing what works for you. I mean, because options are so limited, resources are limited in the minors. Yeah. Yeah. It's wild. Um, okay. So how long, how long have you been out of graduate school? I graduated in December 22. So just over what, not even two years.Yeah. So, so approaching two years and, um, what would you say the biggest impetus to you starting your own company and doing things virtual? Um, what was it, what made you do it? Um, really? I went through clinicals and I, I didn't love it. I honestly like was not, which, you know, I mean, everyone's experience is so different, um, but that sounds exactly.That sounds like my experience. Yeah. Dang. Like, No, that's just not what I had in mind. Like I knew that there was more I could offer people. Um, like I had a background as an athlete. I had great physical therapists in college as well that like really influenced my decision to go to PT school. And so my clinicals just didn't.Really line up with that. Um, so I just felt like there was more I could offer. He also was a big influence in that because we were getting married soon. I was like, do I want to sit back and have a nine to five job that I don't love? Or do I want to build something that like I can be proud of that I, that I'm excited to go to every day.And that kind of fits better with my lifestyle. And that's kind of how I stumbled into the virtual scene. Um, but yeah, that's kind of how I, Okay, but let's let's yeah, let's dissect that a little bit. What, what did you hate about your, um, rotations or your affiliations, whatever you guys call them. Um, and could you have done anything to change that?Um, I felt like I really enjoyed my CIs, my clinical instructors. I always like, they were great, but it was just like the model that it was in, you know, the insurance model, it's just. It's really difficult, um, to give people what you feel like they need at all times. Um, I did, I was very lucky in the, my final clinical rotation was more of a one on one.I see people for like 30 to 45 minutes solo, um, which is more than most people can say. Um, but I just felt like it was more kind of like, You know, just kind of going through the motions. I saw people twice a week. It was just very monotonous. I didn't feel like I had a good grasp on, I didn't feel like I had a lot of control over what they're doing outside of PT.So it's really hard, um, to truly give them the product. Like right now, whenever I work with people, I have like full reign over their training, over their rehab. Like I know what they're doing. Communication. Whereas I felt like I was getting like an hour a week to try to make a big change that kind of didn't feel possible for me to make.Um, so that was the biggest thing for me. I just felt like. And I, as a student, I also just kind of was like, kind of not copying, but like, if I saw them doing that, that's what I was going to do. So it just felt like I wasn't growing or learning. I was kind of going through the motions and just kind of checking off boxes.Okay. So I totally get that. And I think that's why our profession gets a terrible rap, um, because 90 percent of PT looks like exactly what you just described. If you were to give Reagan Langley years, Advice while you were going through that, what would you tell her to try to get more out of those experiences?One I mean just like I was saying like with rehab and athletes like taking it in your hands like your own advocate I felt like I should have looking back. I'm like I could have started a lot sooner like since then i've done mentorships I've done continuing education, but at the time I just in my mind I felt like I have to be all in here like I shouldn't Go look for my own like learning opportunities, but that is the biggest thing I would say to myself.I could go back and the students now like it's never too early to start looking for outside resources and learning and growing, especially and if you have like a certain niche that you want to get into. I also that was another thing I was working with kind of an older population, just not where. Not a population that I knew I wanted to work with long term, so it was really hard, um, just like for my own interest, um, to really be passionate about that.Yeah. Yeah. So, so yeah, and so what you're really saying is you should have taken the true sports ACL course while you were a student. So to all those students out there, take it now. Um, cause it's, it's really important. Um, and, and I would say I made the same mistake like when I was going through it is It's like, you know, you're preparing for the boards, so that's your body of knowledge.You're trying to kind of apply that body of knowledge, but I wasn't looking outside of that textbook to really apply those interventions. Um, and it sounds like kind of, that's where you were. What about with picking? Your rotations. I'll tell you real quick, like my experience with that. So I went to university of Maryland and they said, do not, whatever you do, do not try to set up your own rotation.We will handle that. You tell us what you want to do and we will take care of you. And that put me. Surrounded by geriatrics. Like I couldn't find an athlete if I wanted to. Um, I did eventually set up my own manual rotation kind of behind their back. Good thing they never listened to this. Um, and, and so I set that up in New York on my own, kind of put it, made them think that they were doing it, but I set that up, what was it like for you?Where'd you go to school and did they give you any autonomy to set this up yourself?Yeah. So I went to Baylor. Um, I think you've had Megan. Yes. She was vice president of our PT class. Like the, she's a PT. I look up to then and now, um, she's amazing. But so I, we were in the same class at Baylor. Um, so they, it was kind of an in between that. So they definitely took the reins and wanted, I, we were able to kind of give a couple options, um, that were in our area.And then they kind of chose from there. I think one, I got one of the, the rotations that I kind of sought out, which was my first one. And I really loved it. And I actually, I really enjoyed it as like a first time, like dipping my toes into a rotation. Um, but then the, my second and third I think we're kind of a little bit more random.Um, it also was kind of soon after COVID and all that. So options were a little bit more limited. So I was just kind of happy to get whatever I could. I had some classmates who did rotations until like the week before. So it was more of just like, you know, get what you get and just be happy that. You know, you have somewhere to be in the next few months.So yeah, I definitely felt that was another thing looking back. I'm like, I wish I would have advocated for myself more and really, you know, done more digging and, you know, pushed for certain things. I mean, it sounds like there's a theme there, right? You, you wish you would advocate a little bit more for yourself.Um, and I think that that's great advice to the student or even the young PT to advocate for yourself. I'll say now on our other side, we're going to have between 30 and 40 students come through true sports this year. Um, and so now that we're on this side of things, I love getting DMs from PTs around the country saying, how do I become a student with you guys and them taking the reins because that triggers us to say, we'll reach out to your school.We'll set it up. I'll pretend like I never heard from you. Cause I don't know what your school's rules are. But if you're interested in coming to true sports, I'm interested in having you here. Um, and that kind of kickstarts it. I wish I would've done more of that. It sounds like maybe you could have done more of that.Um, in hindsight, but you know, hindsight is 2020 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. So did you always know you were going to be a business owner? No, I didn't. Um, I always, you know, had the idea. I feel like a lot of PTs are like, Oh, one day I want to, you know, start my own thing.I want to do this. So I've always saw it as down the road. Um, Um, you know, once life kind of settled down, I had a lot more experience, more mentorship, things like that. Um, so I didn't really, while in PT school, really feel like I was going to start something right out of school. That's kind of just, you know, how when life throws things at you and opportunities arise, um.You know, I kind of just grabbed them and ran with it. Uh, because originally I started it after boards. It's kind of how I got into the online space. I kind of started a fitness business online and was just kind of like coaching people. Um, but then I kept finding people like, you know, they knew I was physical therapist.And obviously when you're, even as a, it's just a coach or a personal trainer, like you need to, you know, be able to work with people who are, you know, have aches and have pain. So I felt like I was doing that a little bit anyway. Um, so it really morphed itself kind of back towards. More of a rehab, like fitness forward type platform.Um, that's kind of how I got, how my story kind of started. I mean, it sounds like it's working. So walk me through the business plan, um, for your online PT business. Yeah. So my business plan, um, so is this more of like, how do you have an ally, like find clients? Yeah. Do you have an actual business plan? Like, did you set that up before you started seeing patients?How important is that? So it is so important. And that's something I didn't start from the beginning. So I kind of had to, I was working in the online space. Um, I knew I wanted to kind of, you know, turn it more towards rehab, not just like fitness coaching and workout plans and things like that. So I kind of had a backtrack.And because I, you know, once you start taking on more clients and you get your name out there, um, if you're not like really structured and set up, it kind of just becomes a hectic free for all. Um, and it's really good to have a plan and for your clients to know, okay, this is how this is going to go. This is our relationship.This is what you can expect from me. And that's good for me to have expectations too. So yeah, I definitely had to back it up a little bit. Um, I had to clean up my systems, like all the backend things. Um, Because especially as a new grad, you're trying to, you know, grow as a physical therapist and learn a lot and then you're also like, wow, I didn't take business and in college and I didn't learn all these things.So it's kind of like learning a new skill set, um, finding a great business coach. Someone who can give you guidance and direction is so important. If you're going to go into the online space, even if you're not a new grad, Um, but that was definitely something that really helped me. Um, yeah, well, I love that you did it so early.Cause I did that much later in my career. Once like the business was already rolling. I'm like, what the hell is a profit and loss statement? I don't know what that looks like. What does forecasting look like? I don't know how to do, like, I don't know what any of those words mean. And, and by the way, in college, I would have run from that.That just would have terrified me. So you, you took your step back early. Give me more specifics. Um, yeah. How'd you find a business coach? What did they teach you? What do you wish you would have done from the onset? That's three big questions for you. Yeah. So I originally started with just like, I found like an online, like fitness coaching platform that helped me kind of kick things off really quick.It was more fitness focused. Um, I felt. It was very helpful in getting me in the online space, but I didn't feel like I learned a lot about my business itself. So I was kind of just like on the online space, it was, everything was kind of messy. Um, I started working with Dale Bartek. Um, I don't know if you know him, but he's in the online space.He really helped me. He is a petal hell on the pod, but nice little shout out for him. Cause he obviously did something that worked for you. No, yeah, for sure. He, he was really instrumental in helping me kind of back up and say like, okay, let's, let's make this a little bit more professional. Um, he helped me to kind of create a website.Um, Kind of start working on like funnels. Um, so I, I do like all of my like back and stuff through Kajabi, which has been really helpful to keep everything in one place. Um, it really shows you, you know, your profits, your loss, you know, all the, all the big business terms, uh, taught me, um, a lot about marketing myself.Um, kind of structuring, like how to, you know, get clients, um, how to kind of convert those like leads into like more like sales, like actually selling programs and, you know, keeping clients as well. Um, so I have more of like an overarching, like month to month plan, like how I want to go about, like how many clients I want to take in, um, to kind of keep myself at a level that I want, like how much.Income I want to be making each month. So it really just helped me see things more as instead of just like one big like yearly Like okay, what happened like that's been 12 months what's happened then look at it more as you know month to month Like how are we doing? Um, do we need to do more here or less here?um But yeah, so it's been great. That was great. Yeah. That, that sounds awesome. What kind of, what kind of capital does it take to get that off the ground? Um, I think, I think the initial investment working with him was, I want to say it was around, I mean, his prices might've gone up. This was a while back, but I think it was about 5k to just get.He was kind of starting, like he kind of used me, even though I already had an online space, we kind of used it as like kind of back from the ground up because I really did want to back up and kind of like refresh and restart, um, and make sure things were going smoothly. Yeah. Okay. So 5k there. And then what other kind of investments did you have to make in this thing?You have to get like a certain type of camera. Did you have to get, um, Reagan Langlear's gear? Do you have to, like, what do you have to do? What other costs are there? Mainly the costs are obviously it's the overhead so much better or, you know, than if I was, uh, like had a physical business. So really you just have to pay for, um, I use Stripe as a payment.So it's like a monthly payment there. I use ever fit as my coaching platform. So that's another monthly payment based on like how many clients you have. Um, let's see, I use type form for like intake forms and whenever clients come to me to fill things out. So there's just a bunch of monthly costs, like smaller, like, um, the ever fit one's a little bit bigger.I do a yearly, just so I have like the capacity to take on more clients without having to like up the charge every month. Um, but a lot of the other things are more like 10, 15 a month. So. Um, in the grand scheme, it's not a ton. I think it's worth it. I've tried to use the most, um, like seamless platforms that work together.So Kajabi has been very helpful in doing that. Cause it kind of keeps it all in one place. Do you have, do you need a videographer? I eventually, that's something I want to work to, but right now I just do it all on my own. Um, I use like either like a DJI camera or just my own phone for a lot of. What I send to clients and all of my programs I create.But other than that, I just use like my, like I use zoom for all of my coaching sessions. Just that's, um, so that's awesome. So barrier to entry is somewhat low. I mean, um, That's, that's really awesome to hear. What about, um, advertising and marketing? Do you do any digital marketing or advertising? So right now my Instagram is the only form of marketing and advertising that I use.Um, I don't do any paid ads or anything like that yet. That's something that we talked about possibly returning to in the future. Um, if I was looking to, you know, scale and grow a little bit more, but yeah, right now it's just all social media. Um, and then what is who, first of all, who runs that email marketing for you?Do you do that? So just myself. Yeah. Right now it's, I'm, it's just kind of like a one woman show at the moment. Um, hopefully in the future as things in personal, I've kind of slowed down a little bit. I'll look to scale on like add a coach and grow my business from there. But right now, yeah, it's just me kind of, well, your husband's in the big leagues.I don't see it slowing down anytime soon. You're going to get to Vegas. What is it next year? Next, within the next three years, that's not, that's not where things slow down. So buckle up Reagan. Um, so. Those, those, those things aside, um, tell me what, what is the horizon of this thing? What do you want to do with the entire platform in business?So really I just like, this is what I've talked with a lot of my business coaches in the past about is I just want to get really strong and in my current business, I'm not looking to grow right now just because life is really hectic and I want to be able to give the best product and, um, really have my clients feel like they're getting the most out of their investment with me.Um, so. I'm kind of keeping it where it's at right now. Just really refining my systems, refining my product, my processes. Um, it's like the onboarding process, just making things feel so much more clear and smooth for myself and my clients. Um, so that's kind of what I'm working on now. It's just, you know, really refining the onboarding, offboarding process.Taking time to do more con ed, learn a little bit more, um, grow as a clinician myself, because I feel like this is kind of a cool another side note, but just, you know, when you, when you don't have that built in mentorship from, you know, like your first time job or anything like that, like, I really have to search out those opportunities.Because the world of physical therapy is obviously always evolving. New research is always coming out. You have to be a forever learner in this profession anyway. So just, especially when you don't have that built in mentorship, you just have to really search it out. So I'm trying to, you know, carve out some time to make sure that that's a priority as well.You sound like a business owner. This is awesome. So, um, as you continue. It's awesome. As you continue along this road, do you, do you want to hire others? Like, do you see that as a way to grow the business? Do you just want to be able to expand your bandwidth, whether it be via technology or other things?What's your dream with this? Once you get stuff ironed out, Yeah. So I feel like initially, like my, in the next five years, I really want to grow my own van and feel comfortable, like, you know, taking on more and through technology, like using those resources so that I can maximize like my potential before adding on anyone.Um, I feel like it will be a few years before I add a coach because I want out my business to be like rock solid. I want to be able to bring someone in and say, this is how this runs. Um, Like this is, you know, my, how are you, how are you going to know you're there? I think, I think that's something that entrepreneurs struggle with.Yeah. It's something that I struggle with massively is like how that I started this whole thing thinking, I just want the best place to treat. So how do I construct a business model? Be able to keep the lights on so that I can keep providing awesome care in person. Um, and then all of a sudden I'm like, crap, I can't keep up.I need to hire. Like I kinda got slammed with it. So I wasn't really sure when. I was ready to bring someone on. How are you going to know when you're ready? You know that that's something that I've been asked multiple times in the past few months, and that's probably something else I need to start marinating on, you know, internally on my own, um, because I am someone who's like perfectionist mindset, like, you know, nothing's ever it's never like just how you want it to be, which is.And the big push, that's one thing I regret in starting my business is like, I, I didn't, you know, push in certain things because I was like, Oh, I'm not ready. My product's not ready. My business isn't good enough, but you know, you're never, it's truly, you're never ready. You're never there. So, um, like a lot of what I've learned is kind of just jumping at some point.So I feel like one day I'm just, it's gonna, you know, I'm just going to have to say like, this is good enough. And this is like where my business is right now. And, um, it won't ever be like the. The most perfect version that I'm like shooting for. But honestly, if I bring someone else in, it could, you know, take more positive steps forward, be able to help more people be able to deliver better care.Um, because my mind won't be, you know, just scattered on. Yep. Volume more, you know, I always say quality over quantity, which I feel like is so important in rehab. So I always want to keep that level of care that they feel like I'm not just like running through clients, but more so like giving full effort.That makes total sense. I would say some unsolicited advice. Um, would, and as a guy who sucks at sleeping, something that helps me sleep at night is understanding what, what is my target to know when I need to bring someone on or when I can bring someone on. So that's how many visits am I doing? Um, how many visits is a clinic doing that they can support another full timer.And then before I bring on that full timer, what is the onboarding process? We have a COO that works with us, a guy named Tim stone, who has been Unbelievable with creating our onboarding from a hiring perspective. What's it like to learn how to be a true sports PT? Um, what is, what's the interview process for us to test, whether they'd be a great sports PT, a true sports PT, what is their first week, second week, first month, first year?What does it look like and how do you march them through it? That's when you say, uh, marinating on, I think was, was your term. I think that's something that would be awesome to marinate on because then you, now you have more immediate targets versus when I feel like it, you know, numbers, numbers don't care about your feelings.Right. So what are the numbers you're chasing? Um, in order to help you sleep at night, at least that's the way I look at it. You know, take it or leave it. So, um, it's, it sounds like you got, you have an awesome head on your shoulders and like a great vision as to kind of where you want to take it. Yeah. Um, let's get a little bit clinical because when I'm scouring the Reagan Langlear's Instagram page, um, I see you have an uncanny ability to give patients or athletes options for a given goal.So we want to target your quads. Here are a million and one ways to hit your quads because it's going to work differently for everyone. Or maybe you don't have a hack squad. Maybe you need to be using a foam roller up against the wall. Like you put on one of your posts, stuff like that. So you can isolate it.Right? So talk to me about the terminal knee extension, the TKE. This exercise Reagan is my least favorite exercise in all of rehab. However, it looks like it's your favorite. Favorite exercise. So convince me that I am wrong about the dreaded TKE. So TK is, I wouldn't say it's my absolute favorite, but I do think it has value.Um, I think it's a good tool. Um, do I think it's a good tool for, you know, late stage knee pain, things like that, probably not. There's a way, but you know, we can load it. There's different ways to treat that. But for someone who has trouble either. Activating their quads. Some people, I have a lot of girls come to me.I'm like, I'm just so hamstring dominant. I'm just so, I feel like the TK is a great way to be like, you know what? Here, like you're physically seeing your quad fire. Um, it's a good primer kind of just more mentally for them to be like, okay, like my quads are working. So I like to use it more as like a mental, like.Okay. Our muscles are firing. Let's let's use it as a primer before we really get into, you know, the meat and potatoes of like our workout or our rehab. So I feel like it has time and a place. It's definitely not for everyone. Um, or for every even like knee pain client, but I think it has some value. That makes sense.So you like it because it gives you the tactile cue posterior knees so that they can pull it back. My patients love using their glutes and hamstrings to accomplish that maneuver. Right? So. How do you coach them out of that? And I think this is exceptionally challenging when you're doing it virtually. So how do you handle that?Totally. So just in general, working virtually and not being there hands on to physically, you know, grab the quad and say, this is what I want firing. Um, I've just had to really learn how to, um, um, Like I've had to be really good at, you know, queuing can't tactile cues. So I really have to use your verbal cues.So a lot of times I really like, you know, say push back into the band. Um, like I really want, I like to put them in different positions as well. So sometimes that normal TKE, just standing banded, um, it's really easy for, you know, those glutes to override, to use other things, but I like doing it in a quadruped and different positions, playing around with my clients.And, Giving them options, even in their workout. So you try these few different ones. Like which one do you like, can you feel your quads more working? Give them some options because everyone's different and everyone compensates differently too. Um, so that's been helpful for me just kind of giving them options, letting them play around with certain things, um, and seeing what works best for them.When we're doing our eval versus, so that makes sense. And that's something that I would do if they're in person with me, for sure. I can totally commiserate, especially going through COVID, like how many words I wasted trying to teach people virtually was very challenging for me. One thing I love to do is put, um, Easton on the quads early on.If someone forces me to do a TKE, I'll put stem on the quad to do the TKE. Is there any, um, I guess, is there any scenario where that patient has e STEM where you can like work that in, I guess the more. Overarching question is how do you handle rehab sessions when you don't have access to simple things like blood flow restriction and stim, which are just hallmarks of what we do in office.Totally. So I've had only one to two clients who actually have access to e Stim. Just. from previous rehab experiences and we have utilized it in those situations. Um, so, but, but usually the main, like the theme is I don't and I really have to like work with what you have. So one, whenever I'm like having an initial consult with clients, I'm very honest on if I feel I can help them or not.If I really think that they, that they would truly benefit more from blood flow restriction or they need that e stem, um, especially with post op clients, I'm very, um, I'm very honest on, you know, my, like how I can help them or if I feel like they, if I need to refer them to an in person PT. So that's like just from the get go, um, I'm not just going to take anyone and everyone who comes in because I want to offer them the best care.And if I don't feel like I'm the person for that, I'm a hundred percent. Okay. With saying that and sending them, you know, referring them to someone who I feel like, um, but then, yeah, so a lot of my clients are. They are not as post op. So it's been, it's either like they had an ACL surgery two years ago that just hasn't, you know, hasn't clicked, hasn't gotten back to full.Um, they didn't have the resources to really get them back to true, you know, back to the field, like they kind of just stopped at the table and didn't really have that bridge between their rehab and their like performance goals. So that's kind of where I sit. I like to see myself. I'm kind of like the gap.So I like to, Kind of pick up where like their rehab might have left off and really scale them from there. Okay. What do you think about this? This is a crazy idea that just came to my head while you're talking. Why don't you reach out to our e STEM provider? Why don't you reach out to our BFR provider and offer this to your patients?And they, they're coming in to see Regan Langlear's because she's a stud. She, they want to work with you. You think it would help them to have STEM? Or BFR or whatever, here are a list of providers that, um, I don't know if the word that I'm looking for is providers. Here's our list of, um, our partners.They'll drop BFR, a BFR cuff at your place. They'll drop Easton at your place. Um, by the way, there's probably a way you can work at where you get a cut for referring them, but they're somewhat affordable and you can put it through insurance. What do you think about that? No, I think that actually would be a great option.I'd have to kind of dig into it a little bit more because I, at the moment, like I do not work at all with insurance for what I do now. So I probably have to tinker with that. Like how that would work if I did get a cut, which I wouldn't. If I didn't, that would be totally fine with me. They could have access to that.Cause it would just make my life a little bit easier. It might expand your patient population. Right? Because now you can see the post ops that you don't have to worry about. You never have to send anyone to true sports because you can handle it. Yeah, totally true. And that's a great, that's a great thought.I'll definitely dig into that. I could also even like bands, bands or, um, like gym equipment, just, just have your preferred outlets that. You'll you'll handle it. And, and, you know, they handle the monetary side. Okay. Worth worth thinking about. So, um, okay. You convinced me, I guess a little bit on TKE. I'm still not a TKE guy because I think there's just so many ways to cheat.Um, but I'm sure I've used it at some point, um, in my career. So, um, can you walk me through what it looks like when a patient finds you and then your entire structure of eval cost and then how long they stick with you? Yeah. So usually again, my marketing's all through Instagram. So that's how almost all of my clients have found me either through Instagram or through word of mouth.Um, so I have a website and the link in my bio, they'll go fill out a form, set up a call. Um, so the first call is just a 30 minute initial consult. It's just a good time for us to kind of dive into what they're dealing with while Why they are like searching out, um, some guidance in their rehab, um, what their goals are.And then we kind of just chat and talk about, you know, what it might look like working together. I explained to them what my evaluation process is like, um, what my program is like. Just, you know, what the length of time might be initially. Um, and then we set up a call time for an evaluation and we go from there.So the evaluation is usually 45 minutes to an hour. Um, it's just like it would be in a normal physical therapy setting. We sit down for the first chunk and just kind of chat. We just chat about, you know, their past injury history, their current injury, you know, what, what hurts worse, what makes it better.Um, All the factors running that I love to dive into more of lifestyle factors, like their sleep, their nutrition, um, their stress levels, things that, that are like kind of the behind the scenes, but huge impactors in recovery and rehab, we spend half the time just chatting about all those things, really getting a good picture of where they're at, where they want to go, um, goals, their current activity levels.So all of those things really helped me to formulate. The rehab program, what they need of rehab program, what might be lacking. Um, but we also kind of dive into strength, mobility, um, kind of do, um, range of motion screening, all of those things, depending on what they're coming to me for. So with all of that, I then tell them kind of like what the plan is going forward.And on that same call, we kind of chat about if they're ready to move forward. We, um, Oh, I totally skipped on that. So usually they buy a package in the initial consult call. And that's when we set up our eval. And do all this going forward consult is free Um, yes, the initial consult call is free it's really just time to chat and see if you know, we're good fit to work together because um, again, like as of now I like to kind of screen out make sure it's something that I have I have Like the resources to help them fully with, if it is more acute or if it is post op or something like that.Um, but yeah, then we chat about timeline pricing. I like to start all my clients off with a minimum of a 12 week commitment, um, just to give me time to truly help them, um, you know, set a foundation for whatever they're dealing with and scale back to performance if needed. And then after that. Um, they can either resign or we go month to month, depending on, you know, is it, is it, is it visits over 12 weeks or it's just a 12 week block?How often are you seeing them? It is a 12 week block. So how I structure it, we talked about on the consult call as well. I do weekly check ins, which is kind of where I, Figure out if I need to modify things, I need to progress things, regress, whatever I need to do. And then we have monthly milestone calls.And so this is the time where we retest a lot of things. Um, we kind of chat about, you know, refocusing on goals, making sure we're moving in the right direction. So the weekly check ins are the biggest thing. Um, With making progressions and things like that. And then the monthly milestone calls is like when we're looking just like this face-to-face retesting things, asking questions, going through more of like our visits.Um, so yeah. And are the, are the check-ins, synchronous, are you on a call with them or that's like they're giving you information, so online or asynchronous? So it's all through my platform. I use the Everitt app. So I send out a form every either Friday or Sunday, depending on what we decide. Um, and so they get that back to me.And so I have everything kind of modified if needed changes made by that next Monday. Um, and then they have access to message me anytime through the app. I love when they send me videos, we do a lot of form checks. Um, so even though I'm not there, I feel like I have. A way better grasp on what they're doing and even their workouts, because most of my clients send me videos of all of their, um, yeah, so it's, yeah, so I definitely have, and I love that because I keep tabs on it.We can track progress, um, even on performance and form and things like that. That's awesome. How do you, how are you testing range of motion? Like what tests can you go through virtually? So a lot of, I do range of motion wise is in my eval. So, um, I just look at a bunch of different, we look at hip mobility, I take pictures and I record the session so I can always look back at it.So it's not as much about like the exact goniometer measurement, um, but it's more. Comparing photos, um, also usually a lot of the range of motion things put them in positions that are more aggravating. So it's also about like symptom tolerance, um, things like that. So just things I track. Usually it's client to client based on, you know what they need, but I do have a good structure going in that I like to look at.Um, and then we'll kind of dive into more like special test type movements as well if needed. Hey 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 Table.to turf and the reason we call it that is because it's gonna 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. Do you think it's ever worth it to, um, use like open source, Google stuff that can actually measure ranges of motion?Um, markerlessly. Yeah, I've been playing around with stuff like that. Um, but sometimes I think we can get a little too focused on the number and not as much on the function and that's something I prioritize a little bit more is, you know, how are we feeling? Like having that good communication? Like, what does this feel like to you in comparison to keep taking those notes?So sometimes I do feel like it depends on the client. Like sometimes I'm like, it would be nice for like more of a post op client to have like the perfect specific measurements, like definitely that's why I'm kind of diving into some resources like that. But for a normal client who's, you know, having some hip pain, having some knee pain, um, I don't feel like it's always Access like, I don't think it's absolutely needed and yeah, I mean, I think the, the bonus is like, I mean, you're talking to a guy who picks up a goniometer like once a month, like I don't use it a tremendous amount, but, um, perhaps virtually at least you can freeze frame things or at least keep data and say, Hey, you're so much better now versus.Um, when you were now, okay. So they they're filling out forms once a week, you're adjusting their program. Once a week, you're doing another zoom call monthly. You're doing 12 weeks. So you're getting three of those three calls. How much does that cost? So to, for the initial 12 weeks, it's going to be 1200.So I either work and full, I do monthly or bi weekly, um, payment plans as well. Um, but yeah, that's the initial 1200 for 12 weeks. And, and how many patients can you handle at once? So right now with traveling as much as I am, I'm keeping it between like 10 to 14. So hopefully in the off season, when we're in one place, not having places to be games to be at every night, I'm hoping to up that a little bit closer to 20.Um, but right now I feel comfortable at that, like 10 to 14 range. Do you go to every, you go to every game? Just about, yeah, just because he's still, he's still young and I don't want to miss anything important. So he had his first grand slam last time and I wasn't at that away series. So I was like, dang, never again.What were you doing? Why were you not there? I don't know. I think I had, you know, a wedding or something like that to be at, but yeah. Okay. That's crazy. And does the team take you out there or you're like on your own Southwest schedule? We're on our own. Yeah. We're on our own flights. The, the team plan's not big enough for.For all the wives. So we are, we're just making our own flights. That's the other thing. And I have two dogs, so I'm always trying to either fly with them or I gotta find a sitter or something like that. So yeah. Um, so, and, and do you have like a travel buddy, like there are other wives that you're always traveling with?Yeah. So I have, um, we actually live with another, um, couple, another, uh, player, a pitcher and his wife. So we usually travel together, which is nice. And then I have a couple of the girls who all kind of live in similar areas. So travel, we at least try to pair up. Okay. Is it a starting pitcher or a reliever?Um, long relief, long relief. Okay. Long relief. Yeah. Is his preferred catcher your husband? Cause it would be awkward if it wasn't. Yes, it is. Yes. Yeah. They actually were the Braves originally together and both got traded. So we've known them for a while. Okay. Okay. Good. Glad that that was vetted. Yeah. Okay.So you can handle 10 to 14. What what's interesting though, is Reagan, you've kind of answered the question as to when you're ready to at least support another clinician. Also, what's fascinating about your business model, not that you asked, but I will tell you that you. You can like ease someone in far more easily than a guy who's in broken brick and mortar, right?Like you can find an awesome PT who wants to make some extra bucks on the side and pick up one, two, five, whatever they have bandwidth for. And if you can get really tight around what the service is that they're providing and teach them and coach them appropriately, you could scale this thing like crazy.Yeah, yeah, that's definitely it. That's why I'm always like, okay, we'll wait till all soon as we went to off season. I'll figure things out, but yeah, I really need to jump on that now. Cause I, I do feel like it would be. Easy to onboard another coach now that my own onboarding process and offboarding and like, um, like the meat of my business is really set now and it's flowing well.Um, I do think it would, it wouldn't be a huge task to onboard when I think it would be a lot smoother than what I have in mind. I'm just always, you know, you're always pushing it away, like wanting to make it a little bit more, a little better, a little better before you really dive in. You'll, you'll get past that.I guarantee you. Um, okay. So you looking outside in with some inside knowledge, if you were in charge of the Oakland Athletics, what would you change about the way they do rehab strength and conditioning recovery? Um, I guess I'd say I make it a little bit more individualized as well for my husband. He, he has, I mean, with catchers, you kind of have to let them do their own thing because they're Their bodies just go through a lot every single day, especially what he's playing.I think he's going to end up playing like 140 games this year, um, catching nine innings. So hit with him, I wouldn't change anything about it. They kind of let him do what he needs to do. Like if he, if he wants more, like they're, they're with it, but I feel like with the pitchers, it's very like one way, like, Oh, you need to do arm care.You need to do this. Um, and I feel like even for pitchers, like. They need to be more individualized too. Like more is not always more. Their arms are also, um, you know, being put through so much playing such a long season. So maybe just allowing it to be less, um, fitting guys into the box and kind of, you know, I don't want to word it like, cause sometimes they do, it depends on the team probably too, but, um, sometimes it just feels like, you know, they're kind of, Not forcing, but they want guys to do certain things and, you know, everyone's it's so everyone's so unique, everyone's arms are unique, especially with pitching styles and all that.So maybe just individualizing things a little bit more. Yeah. Well, I'll tell you like there are organizations that do it well and use technology to leverage their ability to do that. So I know there are organizations that will go on whoops scores or they'll go on a force plate analysis where you walk into the weight room, you get on the force plates.That's going to dictate what you're doing today. It doesn't take a strength coach to say, Hey, I'm going to write you a program based on how you feel. It's if you found this metric, I'm This is what you're doing. If you fall on that metric, that's what you're doing with leeway. I think that's a good way to go about it.Um, do you think the Oakland athletics still look like the money ball, Oakland athletics, where they're making like players buy their own sodas? No, I don't think, I don't think it's that. Um, close to the movie, but, um, yeah, I mean there, I have no complaints and my husband doesn't either, you know, whatever they need, they have.And sometimes I think social media, especially with like the drama of the A's moving and everything, it can be a little bit drop dramatized, whatever that word is, but, um, but no, I mean, they have no complaints. Yeah, got it. Um, okay. Awesome to hear kind of the backstory of how you got to where you are. And then even like what you would change and tinker with.I think that's awesome. Give me some parting words of wisdom to the physical therapist who is considering a virtual practice. Um, I just say jump in, you know, the time's never right. Um, you never feel ready, but you know, you just gotta put your best foot forward, jump in and kind of learn as you go really, and the pieces will fall into place and you can refine as you go.Yeah, I think that that is awesome advice. Um, Reagan, I learned a ton from you. So thank you for your time here. I will even considering doing some TKS in the future with my patients. Um, but, um, but don't hold me to it. Um, well worth the wait. Thank you for making time for us with, with your crazy schedule.Thanks for educating our population. You and I will be in regular touch. You got a bright future. Well, thank you so much for having me. This was awesome. So I'm honored to be on the podcast. I love listening to y'all learn so much from your page and your podcast. So thanks again. Thanks, Reagan. Appreciate you.We'll talk soon. Okay. Sounds good. Guys. Bye bye. Bye bye.
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