WEBVTT
1
00:00:03.399 --> 00:01:03.840
The the the the between between the
Hi, guys, Welcome to a new
2
00:01:03.879 --> 00:01:08.040
episode of The Factor podcast. I'm
your host, Jessica Riddle. If this
3
00:01:08.079 --> 00:01:12.239
is your first time tuning in,
welcome and thanks for listening. In today's
4
00:01:12.280 --> 00:01:18.079
episode, we kick off a new
training titled Supercharge your Clinical skill Set with
5
00:01:18.159 --> 00:01:23.680
Doctor Benjamin Fergus. Doctor Benjamin Fergus
is the owner of Cornerstone Health, a
6
00:01:23.760 --> 00:01:29.680
clinic in the Chicago area specializing in
helping individuals overcome chronic pain and regain their
7
00:01:29.760 --> 00:01:34.159
quality of life. Through their unique
approach called the Grip approach. Doctor Fergus
8
00:01:34.159 --> 00:01:40.239
and his team have achieved a remarkable
ninety nine percent success rate in treating chronic
9
00:01:40.280 --> 00:01:45.519
pain. They focus on helping their
clients achieve their goals through their foundational fitness
10
00:01:45.560 --> 00:01:49.519
program, which helps them graduate into
a state of clinical fitness. In this
11
00:01:49.599 --> 00:01:55.280
two part training, doctor Fergus shares
his insights on hiring the right team members,
12
00:01:55.760 --> 00:02:00.359
building a collaborative and effective healthcare practice, and achieving clinical and financial success.
13
00:02:01.159 --> 00:02:05.920
Get ready to learn how to differentiate
yourself in the industry, set and
14
00:02:06.000 --> 00:02:09.560
achieve physical goals with your patients,
and discover the power of a team centered
15
00:02:09.560 --> 00:02:15.919
approach. So grab your notebooks because
this episode is packed with valuable tips and
16
00:02:15.039 --> 00:02:30.280
practical advice. Let's get started.
Good afternoon, everybody, thank you for
17
00:02:30.360 --> 00:02:34.479
joining and Jessica, thank you for
inviting me to present to your audience.
18
00:02:35.360 --> 00:02:39.719
Let's jump right in to this concept
of super charging your skill set. My
19
00:02:39.879 --> 00:02:46.080
background is a clinic owner of Cornerstone
Health in the Evanston or Chicago area,
20
00:02:46.199 --> 00:02:53.400
and our practice specializes in helping individuals
overcome chronic pain and get back to doing
21
00:02:53.479 --> 00:02:58.879
things that are really important to them
Again. The way we manage our practice
22
00:02:59.240 --> 00:03:07.159
is with the Grip approach. Grip
Approach that's a seminar and a system that
23
00:03:07.159 --> 00:03:12.520
we've developed to help us have consistent
success with our clientele and a big part
24
00:03:12.520 --> 00:03:19.000
of our program as helping our clients
graduate into clinical fitness via our foundational fitness
25
00:03:19.120 --> 00:03:24.000
program. Why you are here,
I think we can agree we all want
26
00:03:24.080 --> 00:03:29.240
to help a lot of people and
make an impact in our community. Our
27
00:03:29.280 --> 00:03:32.360
community might be as focused as one
to two private clients you work with,
28
00:03:32.719 --> 00:03:38.280
or as broad as you can scale. Additionally, we all want to have
29
00:03:38.400 --> 00:03:43.840
a healthy profit margin for our time
and work investment. Businesses need profit.
30
00:03:44.800 --> 00:03:49.759
Employees need the business to profit,
so I hope that today you can take
31
00:03:49.840 --> 00:03:55.560
what you learn to either launch your
practice or organize your existing practice for greater
32
00:03:55.599 --> 00:04:01.560
success. Supercharge your own skills with
a clue your framework for consistent results,
33
00:04:01.639 --> 00:04:08.520
and make your skills scalable so that
a team can help you achieve your clinical
34
00:04:08.560 --> 00:04:14.479
mission. We can do all of
this with GRIP approach. Success is determined
35
00:04:14.560 --> 00:04:20.240
from the start. Everything hinges on
the initial patient encounter. This success is
36
00:04:20.279 --> 00:04:27.399
determined primarily by the language you choose
when you communicate with your patient. The
37
00:04:27.519 --> 00:04:31.680
questions you ask your patient are teaching
them what you think is important, and
38
00:04:31.800 --> 00:04:36.600
they're going to attach a value or
concern to it. So we need to
39
00:04:36.639 --> 00:04:43.920
ask questions that clearly identify a successful
outcome. I'm going to challenge you to
40
00:04:44.079 --> 00:04:48.600
change your mindset and to change your
language. I'm going to challenge you to
41
00:04:49.040 --> 00:04:55.160
ditch pain interviewing. And before we
get up in arms about that, please
42
00:04:55.199 --> 00:05:01.079
note our clinic has a ninety nine
percent success rate helping people overcome chronic pain,
43
00:05:02.160 --> 00:05:10.360
yet we rarely talk about pain in
our clinic. See patients often feel
44
00:05:10.680 --> 00:05:15.800
under attack by pain. Pain is
bad and things that make me feel pain
45
00:05:16.120 --> 00:05:23.240
are bad. So the patient goal
might be to not feel pain. However,
46
00:05:23.319 --> 00:05:29.600
focusing patient interviewing on their subjective pain
experience places too high of a value
47
00:05:29.600 --> 00:05:33.720
on it. This can lead to
catastrophizing and it can make the outcome goals
48
00:05:33.839 --> 00:05:40.800
focused on something that is fickle and
hard to measure. So focusing on pain
49
00:05:41.000 --> 00:05:46.759
can limit success from the start.
Success is determined from the start, So
50
00:05:46.920 --> 00:05:51.879
before we even get into a physical
examination in my clinic, we do some
51
00:05:53.000 --> 00:05:59.560
goal setting with the patient. These
goals need to be objective and physical goals.
52
00:06:00.319 --> 00:06:06.160
A really good intake form is the
Patient Specific Functional Scale or PSFs that
53
00:06:06.199 --> 00:06:12.480
should be available online that you can
download as a standardized Initially, this interviewing
54
00:06:12.519 --> 00:06:17.600
form and then our interview with the
patient needs to be a goal oriented interviewing
55
00:06:17.680 --> 00:06:26.959
process, asking questions like what tasks
or activities are you finding challenging to perform.
56
00:06:27.079 --> 00:06:30.399
That's a highly valuable question. Yet
it doesn't ask them about pain,
57
00:06:30.600 --> 00:06:35.879
it asks them about function. So
try not to set your goals based on
58
00:06:35.959 --> 00:06:44.519
the highly variable and flammable subjective pain
experience. We're going to go through a
59
00:06:44.639 --> 00:06:50.720
flow of macro, then micro,
then action. First you need to identify
60
00:06:50.839 --> 00:06:59.399
the macro goals or limitations. Next, identify the micro barriers that keep the
61
00:06:59.439 --> 00:07:05.000
patient from the macro goals. Finally, focus your action on overcoming the micro
62
00:07:05.120 --> 00:07:11.920
barriers in order to achieve the macro
goals. Let's see that in action.
63
00:07:13.000 --> 00:07:16.160
First, we need to ask some
questions that lead to success. Here are
64
00:07:16.199 --> 00:07:20.279
a few that I love to ask
my patients. Let's think about the big
65
00:07:20.319 --> 00:07:26.279
picture here. What are some things
that you would like to envision yourself doing
66
00:07:26.759 --> 00:07:30.720
that seem out of reach today?
Now, with this question, that might
67
00:07:30.759 --> 00:07:32.639
be a good thing to ask a
re exam or at the end of care,
68
00:07:33.199 --> 00:07:38.639
but I've found that by asking a
question that way before I even do
69
00:07:38.680 --> 00:07:43.839
an examination, we start to flip
that switch in the patient's mind that they
70
00:07:43.879 --> 00:07:47.920
want to envision something better for themselves. They want to envision a goal or
71
00:07:48.000 --> 00:07:54.199
see themselves doing something that brings them
joy, and then we sort of position
72
00:07:54.279 --> 00:07:59.800
ourselves is a guide that helps them
achieve those big visions. Next, what
73
00:08:00.079 --> 00:08:03.480
would you do today if you didn't
have this problem? Are there some specific
74
00:08:03.560 --> 00:08:09.680
movements that feel challenging or limited today? Can you demonstrate none of these questions?
75
00:08:09.759 --> 00:08:15.639
Ask about that pain factor. However, It's okay if your patient tells
76
00:08:15.680 --> 00:08:20.519
you about pain. We're going to
keep reducing the value of the pain experience
77
00:08:20.920 --> 00:08:28.120
in a safe way by asking more
about limitations and goals and not focusing on
78
00:08:28.199 --> 00:08:35.000
that subjective experience of the pain.
This is your macro goal setting. This
79
00:08:35.159 --> 00:08:39.159
is the recovery roadmap, and I
go through this form before I begin my
80
00:08:39.200 --> 00:08:43.519
physical exam, and we're going to
focus on the bottom box on the right
81
00:08:43.080 --> 00:08:46.279
that I filled out for my patient
Tom, who I saw a few weeks
82
00:08:46.279 --> 00:08:50.960
ago. When I asked Tom his
questions about what he'd like to be doing
83
00:08:52.159 --> 00:08:56.600
or what he feels limited for,
he has some very clear answers. He
84
00:08:56.679 --> 00:09:01.759
wants to celebrate his eightieth birthday by
hiking with his kids at Yellowstone. Great
85
00:09:01.799 --> 00:09:07.399
goal. I love that functional goal
for Tom. Also, he loves strength
86
00:09:07.399 --> 00:09:11.919
training, and recently he sort of
hates strength training. It's not going well
87
00:09:11.960 --> 00:09:15.759
for him, so he'd love to
be able to strength train four days a
88
00:09:15.759 --> 00:09:18.080
week. Additionally, a few times
a year, he loves to take his
89
00:09:18.200 --> 00:09:20.840
kids and go on a golf trip. He'd like to golf for a three
90
00:09:20.919 --> 00:09:24.720
day weekend, but the past few
trips he's been sitting on the sidelines.
91
00:09:26.399 --> 00:09:31.759
So our big macro goals are a
six hour hike, strength training four or
92
00:09:31.799 --> 00:09:35.960
five times a week and a three
day golf trip. Then we're going to
93
00:09:35.120 --> 00:09:39.879
break that down into some steps along
the way that help us get Tom from
94
00:09:39.879 --> 00:09:45.279
where he is today to those ultimate
goals. If we pop on up to
95
00:09:45.320 --> 00:09:48.639
the top box, we're going to
look at our early indicators of success.
96
00:09:50.320 --> 00:09:54.600
So this is through our first phase
of treatment. We'd liked Tom to be
97
00:09:54.720 --> 00:10:00.600
working towards his ultimate goals, So
an earlier sign of success would be walking
98
00:10:00.759 --> 00:10:05.240
half a mile a day, fifteen
minutes of body weight exercise every day,
99
00:10:07.120 --> 00:10:11.600
and being able to rotate his spine
and his hips to about thirty degrees.
100
00:10:11.279 --> 00:10:16.080
All of these small goals will let
us know that we're well on our way
101
00:10:16.120 --> 00:10:20.039
to the ultimate goals. At a
following re exam, we set slightly bigger
102
00:10:20.080 --> 00:10:26.200
goals. Walk two miles a day
for three days a week, and start
103
00:10:26.240 --> 00:10:31.799
to do some bigger functional strength movements
like a bulgarian split squat, kettlebell press
104
00:10:31.919 --> 00:10:35.759
or TRX row. And let's knock
off another element of golfing. I'd like
105
00:10:35.840 --> 00:10:41.480
him to be able to rotate his
spine forty five degrees and begin swinging his
106
00:10:41.600 --> 00:10:46.399
irons. This form will allow you
to sit with your client and determine right
107
00:10:46.440 --> 00:10:50.759
from the start what successful outcomes would
be for you and for the client,
108
00:10:52.320 --> 00:10:56.080
and it's not focused on paints,
all focused on those big goals. Make
109
00:10:56.120 --> 00:11:03.240
sure that you and your patient are
now viewing successful outcomes the same way.
110
00:11:03.279 --> 00:11:09.360
You need to agree on success before
you start. First, acknowledge Tom,
111
00:11:09.480 --> 00:11:13.360
these are some great goals. I
know it can be frustrating to have a
112
00:11:13.399 --> 00:11:18.320
clear idea of what you want to
do but feel like your body's letting you
113
00:11:18.360 --> 00:11:24.799
down. Next inspire we've seen limitations
like this before. In fact, we've
114
00:11:24.799 --> 00:11:28.919
helped a lot of patients overcome their
limitations and get back to their goals.
115
00:11:28.759 --> 00:11:31.960
Our exam is set up in a
way that will make sure we can help
116
00:11:33.039 --> 00:11:39.240
you as well. Finally, agree
on success. So if we're able to
117
00:11:39.240 --> 00:11:43.120
help you get back to hiking,
golfing, etc. Would you feel like
118
00:11:43.559 --> 00:11:48.440
that would be a successful outcome.
Would you feel like this made a good
119
00:11:48.480 --> 00:11:52.240
impact on your life and your health? So we need to agree on success
120
00:11:52.279 --> 00:11:58.320
from the start. The real power
of physical goal setting is as follows.
121
00:12:00.080 --> 00:12:05.480
The patient leaves that goal setting with
a clear vision for success. You haven't
122
00:12:05.559 --> 00:12:13.480
needed to sell or describe any of
your services. You've positioned yourself to be
123
00:12:13.519 --> 00:12:18.200
able to use your entire skill set
to help the patient get to their physical
124
00:12:18.240 --> 00:12:24.600
goals. You aren't hamstrung by fickle
subjective goals and you can objectively measure success
125
00:12:24.679 --> 00:12:30.120
each visit without having to ask the
patient how they're feeling. In fact,
126
00:12:30.159 --> 00:12:33.200
I love to ask how are you
moving or what have you been able to
127
00:12:33.240 --> 00:12:39.120
accomplish since our last session. Here's
a big one. Any skilled provider on
128
00:12:39.159 --> 00:12:45.480
your team can step in and help
them accomplish their goals. Next, we
129
00:12:45.559 --> 00:12:50.840
move into the micro macro first.
Then micro micro is the rest of our
130
00:12:50.840 --> 00:12:54.480
physical exam. In our office.
We need to do some standard exam tests
131
00:12:54.519 --> 00:13:01.519
like vitals, neurotesting, and ortho
testing. Although we do that orthotesting trying
132
00:13:01.559 --> 00:13:07.240
to avoid that pain catastrophize and not
asking too many detailed questions about pain.
133
00:13:07.879 --> 00:13:11.440
Rather test the movements, feel the
function, note the change. Then we
134
00:13:11.519 --> 00:13:16.480
do our focused and functional evaluation.
This is our grip, functional range,
135
00:13:16.480 --> 00:13:24.399
emotion evaluation. It's the real power
of our success. Next, as needed
136
00:13:24.600 --> 00:13:30.919
as indicated, we do some special
tests like neurodynamics labs, images or nerve
137
00:13:30.960 --> 00:13:35.279
conduction studies EKG. You get the
picture. Whatever is needed for the unique
138
00:13:35.279 --> 00:13:41.559
case but everything kind of hinges back
on that focused and functional evaluation. That's
139
00:13:41.600 --> 00:13:58.720
the one that helps us connect our
patients to their successful outcomes. A simplified
140
00:13:58.799 --> 00:14:03.240
version of that first, rule out
anything that poses a risk. Next,
141
00:14:03.519 --> 00:14:07.639
note what you need to for your
standard documentation, and then finally get to
142
00:14:07.679 --> 00:14:11.559
the real stuff. Identify what individual
limitations are getting in the way of their
143
00:14:11.559 --> 00:14:18.799
big goals. Example, loss of
left hip internal rotation and thoracic external rotation
144
00:14:18.399 --> 00:14:24.000
are limiting the ability to play golf. We've connected the micro loss of hip
145
00:14:24.080 --> 00:14:31.919
rotation to the macro ability to play
golf. With micro plus macro, you
146
00:14:31.000 --> 00:14:39.360
have now agreed on big physical goals
macro position yourself to help them accomplish those
147
00:14:39.399 --> 00:14:45.240
goals using your whole skill set,
and found the individual limitations that need to
148
00:14:45.240 --> 00:14:48.679
be overcome micro If you do this, I'm going to challenge you to start
149
00:14:48.720 --> 00:14:54.240
today. If you do this with
every single new exam and re exam,
150
00:14:54.440 --> 00:15:00.440
you will have an office filled with
patients who are a perfect fit for what
151
00:15:00.559 --> 00:15:05.480
you do and are fired up to
get better and accomplish more. Next action
152
00:15:07.480 --> 00:15:16.559
Macro micro action. Each session builds
towards the ultimate physical goals. Success is
153
00:15:16.600 --> 00:15:22.200
not judged by the immediate treatment effects, which can be transient. Success is
154
00:15:22.279 --> 00:15:28.360
judged by progress towards the ultimate goals. Whatever clinical tools you utilize always circle
155
00:15:28.480 --> 00:15:35.559
back to the big goals. Example, we are using this extra thorax exercise
156
00:15:37.159 --> 00:15:41.600
four times a day. That's the
dose, so that your spine can rotate
157
00:15:41.799 --> 00:15:46.320
forty five degrees. That is going
to make your three day golf trip so
158
00:15:46.440 --> 00:15:52.320
much better. Again, we're using
this exercise so that you can overcome the
159
00:15:52.360 --> 00:15:56.480
limitation that's micro, so that you
can get back to your three day golf
160
00:15:56.519 --> 00:16:03.320
trip. That's the macro, that's
the success with this case, what we've
161
00:16:03.399 --> 00:16:07.840
heard the saying only tools a hammer. Everything's a nail. But even if
162
00:16:07.919 --> 00:16:12.639
your only tool is a hammer,
it can still be really awesome at driving
163
00:16:12.679 --> 00:16:17.679
in the right nails. We need
to make sure we're working on the right
164
00:16:17.799 --> 00:16:22.200
things that helps our client move towards
success. So tie your skill set to
165
00:16:22.240 --> 00:16:27.679
the biggest problem to accomplish the patient
goals. And if your skill set is
166
00:16:27.720 --> 00:16:33.279
falling short, if your skill set
is not accomplishing these goals, then you
167
00:16:33.320 --> 00:16:37.000
start searching for what you need to
add to have a better success rate with
168
00:16:37.120 --> 00:16:41.759
that particular problem. Now we've refined
our skill set and made it in a
169
00:16:41.759 --> 00:16:47.480
way we can put it in your
hands with our virtual GRIP program. Let's
170
00:16:47.480 --> 00:16:51.879
take a little look at GRIP approach. GRIP is an acronym. It stands
171
00:16:51.879 --> 00:17:00.159
for Global Rehabilitation and Injury Prevention.
It's an objective assessment that also classifies the
172
00:17:00.240 --> 00:17:06.960
findings and is connected to a treatment
arm so that it's very actionable. We
173
00:17:07.039 --> 00:17:11.000
apply the system with patients as well
as athletes at every level, and I've
174
00:17:11.000 --> 00:17:15.759
been fortunate to teach this to a
lot of providers who are currently translated into
175
00:17:15.799 --> 00:17:22.920
seven languages. Too often clinicians and
trainers feel like they're missing something due to
176
00:17:22.960 --> 00:17:29.799
some inconsistent results with clients because they
might be overwhelmed by an abundance of tools
177
00:17:29.839 --> 00:17:33.240
but not have an excellent framework to
deploy them. So we've developed that three
178
00:17:33.240 --> 00:17:37.759
part framework that empowers you to know
exactly what to do to get great results.
179
00:17:38.279 --> 00:17:41.240
So with GRIP, we want you
to clarity, consistent results, and
180
00:17:41.279 --> 00:17:45.759
then build your reputation to become the
expert. Essentially, the way this works
181
00:17:45.799 --> 00:17:52.720
in a flow is our from assessment, functional range emotion. Then we move
182
00:17:52.960 --> 00:18:00.200
towards corrective exercises and or soft tissue
treatment including joint manipulation. Then we graduate
183
00:18:00.240 --> 00:18:06.000
into strength training. Let's look at
that flow in a different way. Following
184
00:18:06.200 --> 00:18:12.599
our macro goal setting. We start
by identifying the microlimitations using a functional range
185
00:18:12.599 --> 00:18:18.799
of motion screen. This is essentially
a range of motion testing, but it's
186
00:18:18.920 --> 00:18:23.200
not passive, and when we do
the active portion, we have a clear
187
00:18:23.319 --> 00:18:30.720
eye for compensations and a few key
zones of stability, So we're essentially asking
188
00:18:30.160 --> 00:18:37.279
the nervous system to move the anatomy
at a single joint and a single plane
189
00:18:37.279 --> 00:18:41.720
of motion at a time. Then
we rate that for its quantity and its
190
00:18:41.839 --> 00:18:48.920
quality, identifying the biggest limitations.
We then operate on an assumption that each
191
00:18:49.160 --> 00:18:56.119
movement that's at deficit is primarily a
motor controlled deficit, and we confirm that
192
00:18:56.240 --> 00:19:00.920
by using a global reset strategy.
This is a nerve row based exercise.
193
00:19:02.599 --> 00:19:07.759
With a minute or two minutes of
global reset, we can recheck the from
194
00:19:07.759 --> 00:19:11.799
and if we see a substantial change, we know that this is motor control
195
00:19:11.319 --> 00:19:15.839
and it's not tissue and it's not
joint, and we can progress with exercise
196
00:19:17.559 --> 00:19:22.279
until we follow to that point three
on the bottom. Global performance strategies or
197
00:19:22.359 --> 00:19:27.319
gym exercises However, a lot of
cases do need the structural interface to be
198
00:19:27.400 --> 00:19:33.480
addressed, and we've mapped that out
with fascial manipulation and joint manipulation using our
199
00:19:33.559 --> 00:19:41.000
targeted structural interventions. So this is
our simple three part framework to help Tom
200
00:19:41.119 --> 00:19:45.039
go from where he's at today to
that golf trip and hiking trip. Now
201
00:19:45.160 --> 00:19:48.960
there's a resource that's available to you
that will help as we go through the
202
00:19:49.000 --> 00:19:55.000
next section of this presentation. If
you type in in a new window grip
203
00:19:55.160 --> 00:20:00.680
Approach dot com, you'll see this
nice screen and you have to two options
204
00:20:00.799 --> 00:20:04.960
on the homescreen here. One,
you can enroll in this free class.
205
00:20:06.200 --> 00:20:10.799
When you do that, you'll have
immediate access to a five hour seminar that
206
00:20:10.960 --> 00:20:14.759
talks in more detail about what we
do, and it's also going to give
207
00:20:14.759 --> 00:20:19.640
you some great exercises and tests to
use day one. Or you can go
208
00:20:19.680 --> 00:20:25.519
on over to enroll in the full
coursework and that will give you access to
209
00:20:25.640 --> 00:20:30.400
our complete library. Once registered,
you get access to your technique library like
210
00:20:30.480 --> 00:20:33.759
this. This is the Foundations at
GRIP class. This is the free one,
211
00:20:34.279 --> 00:20:38.319
but then the rest of the body
is segmented to lower extremity, upper
212
00:20:38.400 --> 00:20:45.640
extremity or spine, and when we
click into those particular libraries, every technique
213
00:20:47.200 --> 00:20:52.599
is divided by the joint in this
case hip and the plane of motion in
214
00:20:52.599 --> 00:20:59.319
this case hip adduction or media emotion. You'll see our clear test that every
215
00:20:59.359 --> 00:21:03.759
examine provider can use. Then you'll
see how we address that with a corrective
216
00:21:03.799 --> 00:21:08.799
exercise and with a specific tissue technique. So this is meant to be a
217
00:21:08.839 --> 00:21:15.279
map that once the clinician says the
problem is golf, he wants to get
218
00:21:15.279 --> 00:21:21.319
back to golf, the microlimitation is
hip adduction in this case, then you
219
00:21:21.319 --> 00:21:26.160
can take that case and hand it
over to the treating provider, And if
220
00:21:26.200 --> 00:21:30.559
you're the treating provider, you can
access your entire skill set and say,
221
00:21:30.759 --> 00:21:34.359
I know he wants to golf.
I know the biggest limitation is hip adduction,
222
00:21:34.920 --> 00:21:40.359
and here are the five, ten, fifteen things that I know I'm
223
00:21:40.480 --> 00:21:47.119
great at using to recover hip adduction. You can deploy that entire skill set,
224
00:21:47.640 --> 00:21:52.279
retest and get tom onto a's golf
trip. In each video, you'll
225
00:21:52.319 --> 00:21:56.079
also see a little description below with
more information, and you can slide through
226
00:21:56.200 --> 00:22:00.759
multiple joints. So this is the
online sull grip. I encourage you to
227
00:22:00.759 --> 00:22:04.319
get started today. It's free to
do so. To begin with next,
228
00:22:04.880 --> 00:22:11.799
we have a system. Now we
need to systematize your success. With GRIP,
229
00:22:12.079 --> 00:22:15.799
we help you to systematize your clinical
success so that you win every case.
230
00:22:17.559 --> 00:22:22.079
You can do that online and use
your current skill set and then meet
231
00:22:22.119 --> 00:22:26.319
with us in person to tune it
up some. Let's talk about scaling your
232
00:22:26.359 --> 00:22:33.559
success now. The basic economic overview
of practicing in this rehab goal oriented way
233
00:22:33.400 --> 00:22:38.319
is essentially, your patient will be
with you for a minimum of fifteen minutes
234
00:22:38.960 --> 00:22:44.759
and a maximum of sixty minutes.
My exams are typically forty five to sixty
235
00:22:44.799 --> 00:22:48.319
minutes whatever it takes to get a
really clear picture, and my average treatment
236
00:22:48.359 --> 00:22:52.359
session maybe thirty minutes. So that
means with this model, and you can
237
00:22:52.400 --> 00:22:59.480
note this down, a single provider
is limited by roughly six exams and forty
238
00:22:59.480 --> 00:23:04.119
eight tree mints in a completely booked
thirty hour week. So that number the
239
00:23:04.200 --> 00:23:08.079
forty eight treatments. For some of
you, that might seem like a good
240
00:23:08.119 --> 00:23:12.559
goal, an achievable goal to work
for in your first period of practice,
241
00:23:12.640 --> 00:23:17.160
and some of you may already see
a really high volume of a much higher
242
00:23:17.240 --> 00:23:19.799
volume than that, and think,
well, how do I transition to these
243
00:23:19.839 --> 00:23:25.559
new techniques. If I'm limited to
forty eight treatments in a week and a
244
00:23:25.599 --> 00:23:27.720
thirty hour week, so that might
be the dilemma that comes up, but
245
00:23:27.839 --> 00:23:34.240
the overall basic economic overview, you
can plug in your treatment costs with these
246
00:23:34.319 --> 00:23:38.279
numbers and understand how the system would
work for you in your area. But
247
00:23:40.039 --> 00:23:45.119
ultimately, we need to scale what
makes you great. To be most effective,
248
00:23:45.759 --> 00:23:51.440
we need to provide our patient with
a clinician, a rehab specialist,
249
00:23:52.319 --> 00:24:00.000
a soft tissue specialist, and an
exercise specialist. Many of us begin by
250
00:24:00.119 --> 00:24:06.400
building a skill tower within ourselves.
This is how I began, and many
251
00:24:06.440 --> 00:24:11.480
of you do as well. It's
adding one level of skill onto the next
252
00:24:11.119 --> 00:24:15.720
until you are a very effective,
very skilled tower, but you're still just
253
00:24:15.960 --> 00:24:22.200
one piece. Some people build a
team that can work together for a common
254
00:24:22.240 --> 00:24:26.559
goal. In this way, one
individual does not have to have all of
255
00:24:26.599 --> 00:24:33.880
the skills, as long as every
skilled person on the team communicates really clearly.
256
00:24:33.680 --> 00:24:37.920
I started as a skills tower,
but I am convinced in the power
257
00:24:37.960 --> 00:24:44.359
of a successful team. Teamwork makes
the dream work. This is a book
258
00:24:44.400 --> 00:24:47.240
on the right that I recommend to
all of you that are building a team
259
00:24:47.279 --> 00:24:52.319
it's the power of a positive team, great quotes, great mindset. You
260
00:24:52.400 --> 00:24:57.039
are contagious. The energy you put
into your team and culture determines the quality
261
00:24:57.039 --> 00:25:02.240
of it. So as you may
scale and build a team, you have
262
00:25:02.279 --> 00:25:06.000
to have a clear mission for your
practice and some clear energy that you put
263
00:25:06.039 --> 00:25:10.599
into growing the team that you want
to have. Bottom Line, teams can
264
00:25:10.640 --> 00:25:15.079
have a bigger impact on their community
and mission than a single skilled provider,
265
00:25:15.880 --> 00:25:21.880
So if you want to help more
people, you need to scale your success
266
00:25:22.039 --> 00:25:26.640
by building a team that's fired up
and communicates well. I built the Virtual
267
00:25:26.680 --> 00:25:33.599
GRIP program so that providers could build
their skill set but also easily scale their
268
00:25:33.640 --> 00:25:38.640
impact by training their team with that
program. If you, as a clinician
269
00:25:38.839 --> 00:25:45.799
can nail the exam identifying the macro
and micro movements, then GRIP can step
270
00:25:45.839 --> 00:25:52.880
in and train your clinical staff how
to successfully achieve exceptional results. This does
271
00:25:52.160 --> 00:25:59.680
put some issue to an extent for
the examining provider in that your exam charts
272
00:26:00.079 --> 00:26:03.440
need to be communicated so that anybody
can pick them up. You need to
273
00:26:03.559 --> 00:26:08.480
write them in a way that you
clearly identify the big physical goals and you've
274
00:26:08.559 --> 00:26:25.559
highlighted the micro barriers to those big
goals. That's it for today's episode.
275
00:26:25.960 --> 00:26:29.519
Be sure to tune in for episode
sixty, where we wrap up part two
276
00:26:29.559 --> 00:26:33.720
of this training. Doctor Fergus will
discuss how he asks questions about the tasks
277
00:26:33.720 --> 00:26:40.519
and activities that patients find challenging in
order to set objective and physical goals rather
278
00:26:40.559 --> 00:26:45.079
than basing goals solely on pain.
He will also discuss the importance of setting
279
00:26:45.119 --> 00:26:49.799
macro goals and then identifying micro barriers
that prevent patients from achieving those goals,
280
00:26:51.160 --> 00:26:56.079
and he'll walk us through his process
for creating a recovery roadmap, which breaks
281
00:26:56.119 --> 00:26:59.880
down the goals and steps needed to
achieve them. You won't want to miss.
282
00:27:00.279 --> 00:27:04.200
Episode sixty drops in two weeks.
You can subscribe to the Factor podcast
283
00:27:04.240 --> 00:27:08.440
on Apple, Spotify, iHeartRadio,
or the podcast app that works best for
284
00:27:08.519 --> 00:27:11.759
you. Give us a five star
rating to help us grow the show.
285
00:27:12.119 --> 00:27:17.160
Every little bit helps, and last, but certainly not least, be sure
286
00:27:17.200 --> 00:27:21.039
to visit our show notes for special
promotions from our sponsors, a link to
287
00:27:21.119 --> 00:27:26.359
download the PDF of today's full presentation
and view the recorded replay of the full
288
00:27:26.400 --> 00:27:30.759
webinar. You'll also always find a
special Q and a link where you can
289
00:27:30.799 --> 00:27:33.920
submit any questions that you have for
our presenter. We'll see you next time.
290
00:27:37.279 --> 00:27:38.759
Hey guys, if you like what
you heard today, I encourage you
291
00:27:38.799 --> 00:27:48.319
to visit our website at Factor hyphenstore
dot com that's spelled fak tr hyphenstore dot
292
00:27:48.359 --> 00:27:51.920
com to find out more information about
all that we have to offer. We
293
00:27:52.000 --> 00:27:56.160
have a variety of online offerings as
well as our hands on Factor Rehab System
294
00:27:56.200 --> 00:27:59.680
course scheduled in cities around the globe. Be sure to also check out our
295
00:27:59.720 --> 00:28:03.319
event calendar and bookmark any of these
upcoming live webinar dates coming up in the
296
00:28:03.359 --> 00:28:07.319
near future so you can join us
live. And of course, the biggest
297
00:28:07.359 --> 00:28:10.480
compliment we can receive is for you
to help us spread the word to your
298
00:28:10.480 --> 00:28:14.200
friends, colleagues, and classmates.
You'll find all the important links, as
299
00:28:14.200 --> 00:28:17.200
well as info about our sponsors in
the show notes, so be sure to
300
00:28:17.279 --> 00:28:17.920
check those out.
1
00:00:03.399 --> 00:01:03.840
The the the the between between the
Hi, guys, Welcome to a new
2
00:01:03.879 --> 00:01:08.040
episode of The Factor podcast. I'm
your host, Jessica Riddle. If this
3
00:01:08.079 --> 00:01:12.239
is your first time tuning in,
welcome and thanks for listening. In today's
4
00:01:12.280 --> 00:01:18.079
episode, we kick off a new
training titled Supercharge your Clinical skill Set with
5
00:01:18.159 --> 00:01:23.680
Doctor Benjamin Fergus. Doctor Benjamin Fergus
is the owner of Cornerstone Health, a
6
00:01:23.760 --> 00:01:29.680
clinic in the Chicago area specializing in
helping individuals overcome chronic pain and regain their
7
00:01:29.760 --> 00:01:34.159
quality of life. Through their unique
approach called the Grip approach. Doctor Fergus
8
00:01:34.159 --> 00:01:40.239
and his team have achieved a remarkable
ninety nine percent success rate in treating chronic
9
00:01:40.280 --> 00:01:45.519
pain. They focus on helping their
clients achieve their goals through their foundational fitness
10
00:01:45.560 --> 00:01:49.519
program, which helps them graduate into
a state of clinical fitness. In this
11
00:01:49.599 --> 00:01:55.280
two part training, doctor Fergus shares
his insights on hiring the right team members,
12
00:01:55.760 --> 00:02:00.359
building a collaborative and effective healthcare practice, and achieving clinical and financial success.
13
00:02:01.159 --> 00:02:05.920
Get ready to learn how to differentiate
yourself in the industry, set and
14
00:02:06.000 --> 00:02:09.560
achieve physical goals with your patients,
and discover the power of a team centered
15
00:02:09.560 --> 00:02:15.919
approach. So grab your notebooks because
this episode is packed with valuable tips and
16
00:02:15.039 --> 00:02:30.280
practical advice. Let's get started.
Good afternoon, everybody, thank you for
17
00:02:30.360 --> 00:02:34.479
joining and Jessica, thank you for
inviting me to present to your audience.
18
00:02:35.360 --> 00:02:39.719
Let's jump right in to this concept
of super charging your skill set. My
19
00:02:39.879 --> 00:02:46.080
background is a clinic owner of Cornerstone
Health in the Evanston or Chicago area,
20
00:02:46.199 --> 00:02:53.400
and our practice specializes in helping individuals
overcome chronic pain and get back to doing
21
00:02:53.479 --> 00:02:58.879
things that are really important to them
Again. The way we manage our practice
22
00:02:59.240 --> 00:03:07.159
is with the Grip approach. Grip
Approach that's a seminar and a system that
23
00:03:07.159 --> 00:03:12.520
we've developed to help us have consistent
success with our clientele and a big part
24
00:03:12.520 --> 00:03:19.000
of our program as helping our clients
graduate into clinical fitness via our foundational fitness
25
00:03:19.120 --> 00:03:24.000
program. Why you are here,
I think we can agree we all want
26
00:03:24.080 --> 00:03:29.240
to help a lot of people and
make an impact in our community. Our
27
00:03:29.280 --> 00:03:32.360
community might be as focused as one
to two private clients you work with,
28
00:03:32.719 --> 00:03:38.280
or as broad as you can scale. Additionally, we all want to have
29
00:03:38.400 --> 00:03:43.840
a healthy profit margin for our time
and work investment. Businesses need profit.
30
00:03:44.800 --> 00:03:49.759
Employees need the business to profit,
so I hope that today you can take
31
00:03:49.840 --> 00:03:55.560
what you learn to either launch your
practice or organize your existing practice for greater
32
00:03:55.599 --> 00:04:01.560
success. Supercharge your own skills with
a clue your framework for consistent results,
33
00:04:01.639 --> 00:04:08.520
and make your skills scalable so that
a team can help you achieve your clinical
34
00:04:08.560 --> 00:04:14.479
mission. We can do all of
this with GRIP approach. Success is determined
35
00:04:14.560 --> 00:04:20.240
from the start. Everything hinges on
the initial patient encounter. This success is
36
00:04:20.279 --> 00:04:27.399
determined primarily by the language you choose
when you communicate with your patient. The
37
00:04:27.519 --> 00:04:31.680
questions you ask your patient are teaching
them what you think is important, and
38
00:04:31.800 --> 00:04:36.600
they're going to attach a value or
concern to it. So we need to
39
00:04:36.639 --> 00:04:43.920
ask questions that clearly identify a successful
outcome. I'm going to challenge you to
40
00:04:44.079 --> 00:04:48.600
change your mindset and to change your
language. I'm going to challenge you to
41
00:04:49.040 --> 00:04:55.160
ditch pain interviewing. And before we
get up in arms about that, please
42
00:04:55.199 --> 00:05:01.079
note our clinic has a ninety nine
percent success rate helping people overcome chronic pain,
43
00:05:02.160 --> 00:05:10.360
yet we rarely talk about pain in
our clinic. See patients often feel
44
00:05:10.680 --> 00:05:15.800
under attack by pain. Pain is
bad and things that make me feel pain
45
00:05:16.120 --> 00:05:23.240
are bad. So the patient goal
might be to not feel pain. However,
46
00:05:23.319 --> 00:05:29.600
focusing patient interviewing on their subjective pain
experience places too high of a value
47
00:05:29.600 --> 00:05:33.720
on it. This can lead to
catastrophizing and it can make the outcome goals
48
00:05:33.839 --> 00:05:40.800
focused on something that is fickle and
hard to measure. So focusing on pain
49
00:05:41.000 --> 00:05:46.759
can limit success from the start.
Success is determined from the start, So
50
00:05:46.920 --> 00:05:51.879
before we even get into a physical
examination in my clinic, we do some
51
00:05:53.000 --> 00:05:59.560
goal setting with the patient. These
goals need to be objective and physical goals.
52
00:06:00.319 --> 00:06:06.160
A really good intake form is the
Patient Specific Functional Scale or PSFs that
53
00:06:06.199 --> 00:06:12.480
should be available online that you can
download as a standardized Initially, this interviewing
54
00:06:12.519 --> 00:06:17.600
form and then our interview with the
patient needs to be a goal oriented interviewing
55
00:06:17.680 --> 00:06:26.959
process, asking questions like what tasks
or activities are you finding challenging to perform.
56
00:06:27.079 --> 00:06:30.399
That's a highly valuable question. Yet
it doesn't ask them about pain,
57
00:06:30.600 --> 00:06:35.879
it asks them about function. So
try not to set your goals based on
58
00:06:35.959 --> 00:06:44.519
the highly variable and flammable subjective pain
experience. We're going to go through a
59
00:06:44.639 --> 00:06:50.720
flow of macro, then micro,
then action. First you need to identify
60
00:06:50.839 --> 00:06:59.399
the macro goals or limitations. Next, identify the micro barriers that keep the
61
00:06:59.439 --> 00:07:05.000
patient from the macro goals. Finally, focus your action on overcoming the micro
62
00:07:05.120 --> 00:07:11.920
barriers in order to achieve the macro
goals. Let's see that in action.
63
00:07:13.000 --> 00:07:16.160
First, we need to ask some
questions that lead to success. Here are
64
00:07:16.199 --> 00:07:20.279
a few that I love to ask
my patients. Let's think about the big
65
00:07:20.319 --> 00:07:26.279
picture here. What are some things
that you would like to envision yourself doing
66
00:07:26.759 --> 00:07:30.720
that seem out of reach today?
Now, with this question, that might
67
00:07:30.759 --> 00:07:32.639
be a good thing to ask a
re exam or at the end of care,
68
00:07:33.199 --> 00:07:38.639
but I've found that by asking a
question that way before I even do
69
00:07:38.680 --> 00:07:43.839
an examination, we start to flip
that switch in the patient's mind that they
70
00:07:43.879 --> 00:07:47.920
want to envision something better for themselves. They want to envision a goal or
71
00:07:48.000 --> 00:07:54.199
see themselves doing something that brings them
joy, and then we sort of position
72
00:07:54.279 --> 00:07:59.800
ourselves is a guide that helps them
achieve those big visions. Next, what
73
00:08:00.079 --> 00:08:03.480
would you do today if you didn't
have this problem? Are there some specific
74
00:08:03.560 --> 00:08:09.680
movements that feel challenging or limited today? Can you demonstrate none of these questions?
75
00:08:09.759 --> 00:08:15.639
Ask about that pain factor. However, It's okay if your patient tells
76
00:08:15.680 --> 00:08:20.519
you about pain. We're going to
keep reducing the value of the pain experience
77
00:08:20.920 --> 00:08:28.120
in a safe way by asking more
about limitations and goals and not focusing on
78
00:08:28.199 --> 00:08:35.000
that subjective experience of the pain.
This is your macro goal setting. This
79
00:08:35.159 --> 00:08:39.159
is the recovery roadmap, and I
go through this form before I begin my
80
00:08:39.200 --> 00:08:43.519
physical exam, and we're going to
focus on the bottom box on the right
81
00:08:43.080 --> 00:08:46.279
that I filled out for my patient
Tom, who I saw a few weeks
82
00:08:46.279 --> 00:08:50.960
ago. When I asked Tom his
questions about what he'd like to be doing
83
00:08:52.159 --> 00:08:56.600
or what he feels limited for,
he has some very clear answers. He
84
00:08:56.679 --> 00:09:01.759
wants to celebrate his eightieth birthday by
hiking with his kids at Yellowstone. Great
85
00:09:01.799 --> 00:09:07.399
goal. I love that functional goal
for Tom. Also, he loves strength
86
00:09:07.399 --> 00:09:11.919
training, and recently he sort of
hates strength training. It's not going well
87
00:09:11.960 --> 00:09:15.759
for him, so he'd love to
be able to strength train four days a
88
00:09:15.759 --> 00:09:18.080
week. Additionally, a few times
a year, he loves to take his
89
00:09:18.200 --> 00:09:20.840
kids and go on a golf trip. He'd like to golf for a three
90
00:09:20.919 --> 00:09:24.720
day weekend, but the past few
trips he's been sitting on the sidelines.
91
00:09:26.399 --> 00:09:31.759
So our big macro goals are a
six hour hike, strength training four or
92
00:09:31.799 --> 00:09:35.960
five times a week and a three
day golf trip. Then we're going to
93
00:09:35.120 --> 00:09:39.879
break that down into some steps along
the way that help us get Tom from
94
00:09:39.879 --> 00:09:45.279
where he is today to those ultimate
goals. If we pop on up to
95
00:09:45.320 --> 00:09:48.639
the top box, we're going to
look at our early indicators of success.
96
00:09:50.320 --> 00:09:54.600
So this is through our first phase
of treatment. We'd liked Tom to be
97
00:09:54.720 --> 00:10:00.600
working towards his ultimate goals, So
an earlier sign of success would be walking
98
00:10:00.759 --> 00:10:05.240
half a mile a day, fifteen
minutes of body weight exercise every day,
99
00:10:07.120 --> 00:10:11.600
and being able to rotate his spine
and his hips to about thirty degrees.
100
00:10:11.279 --> 00:10:16.080
All of these small goals will let
us know that we're well on our way
101
00:10:16.120 --> 00:10:20.039
to the ultimate goals. At a
following re exam, we set slightly bigger
102
00:10:20.080 --> 00:10:26.200
goals. Walk two miles a day
for three days a week, and start
103
00:10:26.240 --> 00:10:31.799
to do some bigger functional strength movements
like a bulgarian split squat, kettlebell press
104
00:10:31.919 --> 00:10:35.759
or TRX row. And let's knock
off another element of golfing. I'd like
105
00:10:35.840 --> 00:10:41.480
him to be able to rotate his
spine forty five degrees and begin swinging his
106
00:10:41.600 --> 00:10:46.399
irons. This form will allow you
to sit with your client and determine right
107
00:10:46.440 --> 00:10:50.759
from the start what successful outcomes would
be for you and for the client,
108
00:10:52.320 --> 00:10:56.080
and it's not focused on paints,
all focused on those big goals. Make
109
00:10:56.120 --> 00:11:03.240
sure that you and your patient are
now viewing successful outcomes the same way.
110
00:11:03.279 --> 00:11:09.360
You need to agree on success before
you start. First, acknowledge Tom,
111
00:11:09.480 --> 00:11:13.360
these are some great goals. I
know it can be frustrating to have a
112
00:11:13.399 --> 00:11:18.320
clear idea of what you want to
do but feel like your body's letting you
113
00:11:18.360 --> 00:11:24.799
down. Next inspire we've seen limitations
like this before. In fact, we've
114
00:11:24.799 --> 00:11:28.919
helped a lot of patients overcome their
limitations and get back to their goals.
115
00:11:28.759 --> 00:11:31.960
Our exam is set up in a
way that will make sure we can help
116
00:11:33.039 --> 00:11:39.240
you as well. Finally, agree
on success. So if we're able to
117
00:11:39.240 --> 00:11:43.120
help you get back to hiking,
golfing, etc. Would you feel like
118
00:11:43.559 --> 00:11:48.440
that would be a successful outcome.
Would you feel like this made a good
119
00:11:48.480 --> 00:11:52.240
impact on your life and your health? So we need to agree on success
120
00:11:52.279 --> 00:11:58.320
from the start. The real power
of physical goal setting is as follows.
121
00:12:00.080 --> 00:12:05.480
The patient leaves that goal setting with
a clear vision for success. You haven't
122
00:12:05.559 --> 00:12:13.480
needed to sell or describe any of
your services. You've positioned yourself to be
123
00:12:13.519 --> 00:12:18.200
able to use your entire skill set
to help the patient get to their physical
124
00:12:18.240 --> 00:12:24.600
goals. You aren't hamstrung by fickle
subjective goals and you can objectively measure success
125
00:12:24.679 --> 00:12:30.120
each visit without having to ask the
patient how they're feeling. In fact,
126
00:12:30.159 --> 00:12:33.200
I love to ask how are you
moving or what have you been able to
127
00:12:33.240 --> 00:12:39.120
accomplish since our last session. Here's
a big one. Any skilled provider on
128
00:12:39.159 --> 00:12:45.480
your team can step in and help
them accomplish their goals. Next, we
129
00:12:45.559 --> 00:12:50.840
move into the micro macro first.
Then micro micro is the rest of our
130
00:12:50.840 --> 00:12:54.480
physical exam. In our office.
We need to do some standard exam tests
131
00:12:54.519 --> 00:13:01.519
like vitals, neurotesting, and ortho
testing. Although we do that orthotesting trying
132
00:13:01.559 --> 00:13:07.240
to avoid that pain catastrophize and not
asking too many detailed questions about pain.
133
00:13:07.879 --> 00:13:11.440
Rather test the movements, feel the
function, note the change. Then we
134
00:13:11.519 --> 00:13:16.480
do our focused and functional evaluation.
This is our grip, functional range,
135
00:13:16.480 --> 00:13:24.399
emotion evaluation. It's the real power
of our success. Next, as needed
136
00:13:24.600 --> 00:13:30.919
as indicated, we do some special
tests like neurodynamics labs, images or nerve
137
00:13:30.960 --> 00:13:35.279
conduction studies EKG. You get the
picture. Whatever is needed for the unique
138
00:13:35.279 --> 00:13:41.559
case but everything kind of hinges back
on that focused and functional evaluation. That's
139
00:13:41.600 --> 00:13:58.720
the one that helps us connect our
patients to their successful outcomes. A simplified
140
00:13:58.799 --> 00:14:03.240
version of that first, rule out
anything that poses a risk. Next,
141
00:14:03.519 --> 00:14:07.639
note what you need to for your
standard documentation, and then finally get to
142
00:14:07.679 --> 00:14:11.559
the real stuff. Identify what individual
limitations are getting in the way of their
143
00:14:11.559 --> 00:14:18.799
big goals. Example, loss of
left hip internal rotation and thoracic external rotation
144
00:14:18.399 --> 00:14:24.000
are limiting the ability to play golf. We've connected the micro loss of hip
145
00:14:24.080 --> 00:14:31.919
rotation to the macro ability to play
golf. With micro plus macro, you
146
00:14:31.000 --> 00:14:39.360
have now agreed on big physical goals
macro position yourself to help them accomplish those
147
00:14:39.399 --> 00:14:45.240
goals using your whole skill set,
and found the individual limitations that need to
148
00:14:45.240 --> 00:14:48.679
be overcome micro If you do this, I'm going to challenge you to start
149
00:14:48.720 --> 00:14:54.240
today. If you do this with
every single new exam and re exam,
150
00:14:54.440 --> 00:15:00.440
you will have an office filled with
patients who are a perfect fit for what
151
00:15:00.559 --> 00:15:05.480
you do and are fired up to
get better and accomplish more. Next action
152
00:15:07.480 --> 00:15:16.559
Macro micro action. Each session builds
towards the ultimate physical goals. Success is
153
00:15:16.600 --> 00:15:22.200
not judged by the immediate treatment effects, which can be transient. Success is
154
00:15:22.279 --> 00:15:28.360
judged by progress towards the ultimate goals. Whatever clinical tools you utilize always circle
155
00:15:28.480 --> 00:15:35.559
back to the big goals. Example, we are using this extra thorax exercise
156
00:15:37.159 --> 00:15:41.600
four times a day. That's the
dose, so that your spine can rotate
157
00:15:41.799 --> 00:15:46.320
forty five degrees. That is going
to make your three day golf trip so
158
00:15:46.440 --> 00:15:52.320
much better. Again, we're using
this exercise so that you can overcome the
159
00:15:52.360 --> 00:15:56.480
limitation that's micro, so that you
can get back to your three day golf
160
00:15:56.519 --> 00:16:03.320
trip. That's the macro, that's
the success with this case, what we've
161
00:16:03.399 --> 00:16:07.840
heard the saying only tools a hammer. Everything's a nail. But even if
162
00:16:07.919 --> 00:16:12.639
your only tool is a hammer,
it can still be really awesome at driving
163
00:16:12.679 --> 00:16:17.679
in the right nails. We need
to make sure we're working on the right
164
00:16:17.799 --> 00:16:22.200
things that helps our client move towards
success. So tie your skill set to
165
00:16:22.240 --> 00:16:27.679
the biggest problem to accomplish the patient
goals. And if your skill set is
166
00:16:27.720 --> 00:16:33.279
falling short, if your skill set
is not accomplishing these goals, then you
167
00:16:33.320 --> 00:16:37.000
start searching for what you need to
add to have a better success rate with
168
00:16:37.120 --> 00:16:41.759
that particular problem. Now we've refined
our skill set and made it in a
169
00:16:41.759 --> 00:16:47.480
way we can put it in your
hands with our virtual GRIP program. Let's
170
00:16:47.480 --> 00:16:51.879
take a little look at GRIP approach. GRIP is an acronym. It stands
171
00:16:51.879 --> 00:17:00.159
for Global Rehabilitation and Injury Prevention.
It's an objective assessment that also classifies the
172
00:17:00.240 --> 00:17:06.960
findings and is connected to a treatment
arm so that it's very actionable. We
173
00:17:07.039 --> 00:17:11.000
apply the system with patients as well
as athletes at every level, and I've
174
00:17:11.000 --> 00:17:15.759
been fortunate to teach this to a
lot of providers who are currently translated into
175
00:17:15.799 --> 00:17:22.920
seven languages. Too often clinicians and
trainers feel like they're missing something due to
176
00:17:22.960 --> 00:17:29.799
some inconsistent results with clients because they
might be overwhelmed by an abundance of tools
177
00:17:29.839 --> 00:17:33.240
but not have an excellent framework to
deploy them. So we've developed that three
178
00:17:33.240 --> 00:17:37.759
part framework that empowers you to know
exactly what to do to get great results.
179
00:17:38.279 --> 00:17:41.240
So with GRIP, we want you
to clarity, consistent results, and
180
00:17:41.279 --> 00:17:45.759
then build your reputation to become the
expert. Essentially, the way this works
181
00:17:45.799 --> 00:17:52.720
in a flow is our from assessment, functional range emotion. Then we move
182
00:17:52.960 --> 00:18:00.200
towards corrective exercises and or soft tissue
treatment including joint manipulation. Then we graduate
183
00:18:00.240 --> 00:18:06.000
into strength training. Let's look at
that flow in a different way. Following
184
00:18:06.200 --> 00:18:12.599
our macro goal setting. We start
by identifying the microlimitations using a functional range
185
00:18:12.599 --> 00:18:18.799
of motion screen. This is essentially
a range of motion testing, but it's
186
00:18:18.920 --> 00:18:23.200
not passive, and when we do
the active portion, we have a clear
187
00:18:23.319 --> 00:18:30.720
eye for compensations and a few key
zones of stability, So we're essentially asking
188
00:18:30.160 --> 00:18:37.279
the nervous system to move the anatomy
at a single joint and a single plane
189
00:18:37.279 --> 00:18:41.720
of motion at a time. Then
we rate that for its quantity and its
190
00:18:41.839 --> 00:18:48.920
quality, identifying the biggest limitations.
We then operate on an assumption that each
191
00:18:49.160 --> 00:18:56.119
movement that's at deficit is primarily a
motor controlled deficit, and we confirm that
192
00:18:56.240 --> 00:19:00.920
by using a global reset strategy.
This is a nerve row based exercise.
193
00:19:02.599 --> 00:19:07.759
With a minute or two minutes of
global reset, we can recheck the from
194
00:19:07.759 --> 00:19:11.799
and if we see a substantial change, we know that this is motor control
195
00:19:11.319 --> 00:19:15.839
and it's not tissue and it's not
joint, and we can progress with exercise
196
00:19:17.559 --> 00:19:22.279
until we follow to that point three
on the bottom. Global performance strategies or
197
00:19:22.359 --> 00:19:27.319
gym exercises However, a lot of
cases do need the structural interface to be
198
00:19:27.400 --> 00:19:33.480
addressed, and we've mapped that out
with fascial manipulation and joint manipulation using our
199
00:19:33.559 --> 00:19:41.000
targeted structural interventions. So this is
our simple three part framework to help Tom
200
00:19:41.119 --> 00:19:45.039
go from where he's at today to
that golf trip and hiking trip. Now
201
00:19:45.160 --> 00:19:48.960
there's a resource that's available to you
that will help as we go through the
202
00:19:49.000 --> 00:19:55.000
next section of this presentation. If
you type in in a new window grip
203
00:19:55.160 --> 00:20:00.680
Approach dot com, you'll see this
nice screen and you have to two options
204
00:20:00.799 --> 00:20:04.960
on the homescreen here. One,
you can enroll in this free class.
205
00:20:06.200 --> 00:20:10.799
When you do that, you'll have
immediate access to a five hour seminar that
206
00:20:10.960 --> 00:20:14.759
talks in more detail about what we
do, and it's also going to give
207
00:20:14.759 --> 00:20:19.640
you some great exercises and tests to
use day one. Or you can go
208
00:20:19.680 --> 00:20:25.519
on over to enroll in the full
coursework and that will give you access to
209
00:20:25.640 --> 00:20:30.400
our complete library. Once registered,
you get access to your technique library like
210
00:20:30.480 --> 00:20:33.759
this. This is the Foundations at
GRIP class. This is the free one,
211
00:20:34.279 --> 00:20:38.319
but then the rest of the body
is segmented to lower extremity, upper
212
00:20:38.400 --> 00:20:45.640
extremity or spine, and when we
click into those particular libraries, every technique
213
00:20:47.200 --> 00:20:52.599
is divided by the joint in this
case hip and the plane of motion in
214
00:20:52.599 --> 00:20:59.319
this case hip adduction or media emotion. You'll see our clear test that every
215
00:20:59.359 --> 00:21:03.759
examine provider can use. Then you'll
see how we address that with a corrective
216
00:21:03.799 --> 00:21:08.799
exercise and with a specific tissue technique. So this is meant to be a
217
00:21:08.839 --> 00:21:15.279
map that once the clinician says the
problem is golf, he wants to get
218
00:21:15.279 --> 00:21:21.319
back to golf, the microlimitation is
hip adduction in this case, then you
219
00:21:21.319 --> 00:21:26.160
can take that case and hand it
over to the treating provider, And if
220
00:21:26.200 --> 00:21:30.559
you're the treating provider, you can
access your entire skill set and say,
221
00:21:30.759 --> 00:21:34.359
I know he wants to golf.
I know the biggest limitation is hip adduction,
222
00:21:34.920 --> 00:21:40.359
and here are the five, ten, fifteen things that I know I'm
223
00:21:40.480 --> 00:21:47.119
great at using to recover hip adduction. You can deploy that entire skill set,
224
00:21:47.640 --> 00:21:52.279
retest and get tom onto a's golf
trip. In each video, you'll
225
00:21:52.319 --> 00:21:56.079
also see a little description below with
more information, and you can slide through
226
00:21:56.200 --> 00:22:00.759
multiple joints. So this is the
online sull grip. I encourage you to
227
00:22:00.759 --> 00:22:04.319
get started today. It's free to
do so. To begin with next,
228
00:22:04.880 --> 00:22:11.799
we have a system. Now we
need to systematize your success. With GRIP,
229
00:22:12.079 --> 00:22:15.799
we help you to systematize your clinical
success so that you win every case.
230
00:22:17.559 --> 00:22:22.079
You can do that online and use
your current skill set and then meet
231
00:22:22.119 --> 00:22:26.319
with us in person to tune it
up some. Let's talk about scaling your
232
00:22:26.359 --> 00:22:33.559
success now. The basic economic overview
of practicing in this rehab goal oriented way
233
00:22:33.400 --> 00:22:38.319
is essentially, your patient will be
with you for a minimum of fifteen minutes
234
00:22:38.960 --> 00:22:44.759
and a maximum of sixty minutes.
My exams are typically forty five to sixty
235
00:22:44.799 --> 00:22:48.319
minutes whatever it takes to get a
really clear picture, and my average treatment
236
00:22:48.359 --> 00:22:52.359
session maybe thirty minutes. So that
means with this model, and you can
237
00:22:52.400 --> 00:22:59.480
note this down, a single provider
is limited by roughly six exams and forty
238
00:22:59.480 --> 00:23:04.119
eight tree mints in a completely booked
thirty hour week. So that number the
239
00:23:04.200 --> 00:23:08.079
forty eight treatments. For some of
you, that might seem like a good
240
00:23:08.119 --> 00:23:12.559
goal, an achievable goal to work
for in your first period of practice,
241
00:23:12.640 --> 00:23:17.160
and some of you may already see
a really high volume of a much higher
242
00:23:17.240 --> 00:23:19.799
volume than that, and think,
well, how do I transition to these
243
00:23:19.839 --> 00:23:25.559
new techniques. If I'm limited to
forty eight treatments in a week and a
244
00:23:25.599 --> 00:23:27.720
thirty hour week, so that might
be the dilemma that comes up, but
245
00:23:27.839 --> 00:23:34.240
the overall basic economic overview, you
can plug in your treatment costs with these
246
00:23:34.319 --> 00:23:38.279
numbers and understand how the system would
work for you in your area. But
247
00:23:40.039 --> 00:23:45.119
ultimately, we need to scale what
makes you great. To be most effective,
248
00:23:45.759 --> 00:23:51.440
we need to provide our patient with
a clinician, a rehab specialist,
249
00:23:52.319 --> 00:24:00.000
a soft tissue specialist, and an
exercise specialist. Many of us begin by
250
00:24:00.119 --> 00:24:06.400
building a skill tower within ourselves.
This is how I began, and many
251
00:24:06.440 --> 00:24:11.480
of you do as well. It's
adding one level of skill onto the next
252
00:24:11.119 --> 00:24:15.720
until you are a very effective,
very skilled tower, but you're still just
253
00:24:15.960 --> 00:24:22.200
one piece. Some people build a
team that can work together for a common
254
00:24:22.240 --> 00:24:26.559
goal. In this way, one
individual does not have to have all of
255
00:24:26.599 --> 00:24:33.880
the skills, as long as every
skilled person on the team communicates really clearly.
256
00:24:33.680 --> 00:24:37.920
I started as a skills tower,
but I am convinced in the power
257
00:24:37.960 --> 00:24:44.359
of a successful team. Teamwork makes
the dream work. This is a book
258
00:24:44.400 --> 00:24:47.240
on the right that I recommend to
all of you that are building a team
259
00:24:47.279 --> 00:24:52.319
it's the power of a positive team, great quotes, great mindset. You
260
00:24:52.400 --> 00:24:57.039
are contagious. The energy you put
into your team and culture determines the quality
261
00:24:57.039 --> 00:25:02.240
of it. So as you may
scale and build a team, you have
262
00:25:02.279 --> 00:25:06.000
to have a clear mission for your
practice and some clear energy that you put
263
00:25:06.039 --> 00:25:10.599
into growing the team that you want
to have. Bottom Line, teams can
264
00:25:10.640 --> 00:25:15.079
have a bigger impact on their community
and mission than a single skilled provider,
265
00:25:15.880 --> 00:25:21.880
So if you want to help more
people, you need to scale your success
266
00:25:22.039 --> 00:25:26.640
by building a team that's fired up
and communicates well. I built the Virtual
267
00:25:26.680 --> 00:25:33.599
GRIP program so that providers could build
their skill set but also easily scale their
268
00:25:33.640 --> 00:25:38.640
impact by training their team with that
program. If you, as a clinician
269
00:25:38.839 --> 00:25:45.799
can nail the exam identifying the macro
and micro movements, then GRIP can step
270
00:25:45.839 --> 00:25:52.880
in and train your clinical staff how
to successfully achieve exceptional results. This does
271
00:25:52.160 --> 00:25:59.680
put some issue to an extent for
the examining provider in that your exam charts
272
00:26:00.079 --> 00:26:03.440
need to be communicated so that anybody
can pick them up. You need to
273
00:26:03.559 --> 00:26:08.480
write them in a way that you
clearly identify the big physical goals and you've
274
00:26:08.559 --> 00:26:25.559
highlighted the micro barriers to those big
goals. That's it for today's episode.
275
00:26:25.960 --> 00:26:29.519
Be sure to tune in for episode
sixty, where we wrap up part two
276
00:26:29.559 --> 00:26:33.720
of this training. Doctor Fergus will
discuss how he asks questions about the tasks
277
00:26:33.720 --> 00:26:40.519
and activities that patients find challenging in
order to set objective and physical goals rather
278
00:26:40.559 --> 00:26:45.079
than basing goals solely on pain.
He will also discuss the importance of setting
279
00:26:45.119 --> 00:26:49.799
macro goals and then identifying micro barriers
that prevent patients from achieving those goals,
280
00:26:51.160 --> 00:26:56.079
and he'll walk us through his process
for creating a recovery roadmap, which breaks
281
00:26:56.119 --> 00:26:59.880
down the goals and steps needed to
achieve them. You won't want to miss.
282
00:27:00.279 --> 00:27:04.200
Episode sixty drops in two weeks.
You can subscribe to the Factor podcast
283
00:27:04.240 --> 00:27:08.440
on Apple, Spotify, iHeartRadio,
or the podcast app that works best for
284
00:27:08.519 --> 00:27:11.759
you. Give us a five star
rating to help us grow the show.
285
00:27:12.119 --> 00:27:17.160
Every little bit helps, and last, but certainly not least, be sure
286
00:27:17.200 --> 00:27:21.039
to visit our show notes for special
promotions from our sponsors, a link to
287
00:27:21.119 --> 00:27:26.359
download the PDF of today's full presentation
and view the recorded replay of the full
288
00:27:26.400 --> 00:27:30.759
webinar. You'll also always find a
special Q and a link where you can
289
00:27:30.799 --> 00:27:33.920
submit any questions that you have for
our presenter. We'll see you next time.
290
00:27:37.279 --> 00:27:38.759
Hey guys, if you like what
you heard today, I encourage you
291
00:27:38.799 --> 00:27:48.319
to visit our website at Factor hyphenstore
dot com that's spelled fak tr hyphenstore dot
292
00:27:48.359 --> 00:27:51.920
com to find out more information about
all that we have to offer. We
293
00:27:52.000 --> 00:27:56.160
have a variety of online offerings as
well as our hands on Factor Rehab System
294
00:27:56.200 --> 00:27:59.680
course scheduled in cities around the globe. Be sure to also check out our
295
00:27:59.720 --> 00:28:03.319
event calendar and bookmark any of these
upcoming live webinar dates coming up in the
296
00:28:03.359 --> 00:28:07.319
near future so you can join us
live. And of course, the biggest
297
00:28:07.359 --> 00:28:10.480
compliment we can receive is for you
to help us spread the word to your
298
00:28:10.480 --> 00:28:14.200
friends, colleagues, and classmates.
You'll find all the important links, as
299
00:28:14.200 --> 00:28:17.200
well as info about our sponsors in
the show notes, so be sure to
300
00:28:17.279 --> 00:28:17.920
check those out.
