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Key Features of the PRS Sustainable Training Method: Bridging The Gap Between Barbell Training, Powerlifting, & Rehabilitation
Understand how PRS integrates barbell training & powerlifting with physical therapy to bridge the gap between rehab & successful return-to-sport.
In the first episode of the Progressive Rehab & Strength Podcast, head PRS Clinical Coaches Dr. Rori Alter and Dr. Alyssa Haveson introduce themselves and the intricacies of the PRS Sustainable Training Method..
Uncover the key elements of the PRS Sustainable Training Method and understand how PRS integrates barbell training and powerlifting coaching with physical therapy to bridge the gap between rehabilitation and successful return to sport.
Listen as Dr. Rori and Dr. Alyssa explain the importance of rating of perceived exertion (RPE), estimated 1 rep max (e1rm), tracking training fatigue, Athlete Identity, and the Repeat Novice Effect on injury risk reduction in barbell training and powerlifting and successful rehabilitation and strength development across the spectrum.
Episode 1 Transcript:
Dr. Alyssa Haveson, PT, PRSCC, CSCS: [00:00:01] One of the common questions that we get is how do they do this at a mill model practice? How do they do what we do and provide the best possible care and treatment to their patients or clients?
Dr. Rori Alter, PT, PRSCC, SSC: [00:00:18] Welcome to the Progressive Rehab & Strength Podcast.
Dr. Alyssa Haveson, PT, PRSCC, CSCS: [00:00:20] We're your hosts, physical therapists, strength coaches and PRS Clinical Coaches Dr. Alyssa Haveson.
Dr. Rori Alter, PT, PRSCC, SSC: [00:00:27] And Dr. Rori Alter join us on our journey of barbell, strength, training and rehabilitation. Welcome to Episode 1 of the Progressive Rehab & Strength Podcast. I'm your host, Rori Alter, and my co-host here is Alyssa Haveson. We're both doctors of physical therapy, strength coaches and PRS Clinical Coaches. This episode is going to be all about why we're here, why we're starting this podcast, and what the PRS Sustainable Training Method is all about, and how it came to be.
So first, I'm just going to introduce myself. I'm Dr. Rori Alter. I'm a physical therapist, like I said before, competitive powerlifter and have a long history of athletics starting from the age of about 12 with dancing not competitively, but performance, performing arts all through college.
And then I started triathlons in college as well, and I was always injured doing the endurance thing. I absolutely hated running. I loved biking and absolutely loved swimming, but hated the run and was always injured. Met my husband in physical therapy school. He introduced me to barbell training and the rest is history.
But really, I found the barbells to be extremely functional and as I started to get stronger, I noticed all my endurance ailments went away and I realized that barbell training was an effective method of not only rehabilitating chronic injuries, but also acute injuries and working with the older population and younger population integrating this functional strength, which is actually functional strength and not the functional strength that you see on TV or on Instagram, which we could do a whole podcast on.
Dr. Rori Alter, PT, PRSCC, SSC: [00:02:27] I just knew that barbell training was something that I wanted to include in my physical therapy practice, became a highly competitive powerlifter. People started to know that I was also a physical therapist who happened to be a powerlifter, and when the powerlifters were injured, they came to me.
And that is how Progressive Rehab & Strength was founded through becoming a coach, a powerlifter and a physical therapist, and integrating those things and starting to work with competitive powerlifters.
So that's a little bit about me.
But Alyssa, actually, we were having a conversation the other day and it kind of ties into what I was just saying, trying to reach that population of powerlifters who need physical therapy and the problem that we face. So you said something really interesting the other day that powerlifters or barbell trainees who have a negative view of physical therapy or a negative past experience with physical therapy won't really care that we're powerlifters.
And I think that's really important when we talk about what PRS does and how we view physical therapy not as its own entity, but also as a part of training.
So can you dive into what you meant when you said that and just also a little bit about your background as a lifter and physical therapist?
Dr. Alyssa Haveson, PT, PRSCC, CSCS: [00:03:52] Yeah. So when I said that, I was really referring to, like you said, that group of powerlifters that doesn't have a positive past experience with physical therapy either. They've gone to physical therapy and didn't have success or really felt like the physical therapist didn't understand their sport, told them not to not to continue lifting or to pause lifting and didn't have success with treatment.
And I don't know about you, Rori, but if you on at least a few occasions, I've started with powerlifters who are injured and they've said:
“Well, do you really coach other lifters?”
“Do you coach lifters that aren't injured? Like, do you really know what powerlifting is?
“Are you a physical therapist?”
And just to pull my background into this, because my answer usually involves that is that my, my background is very similar to yours, but it's kind of flip flopped. So I was a competitive powerlifter and barbell coach for about five or six years after finishing undergrad. And my experience with that was that sometimes clients were injured or had symptoms or needed surgery. And during the process of working with me, they were in physical therapy.
Dr. Alyssa Haveson, PT, PRSCC, CSCS: [00:05:04] And the issue I would encounter is that the physical therapist wouldn't really trust me to give them guidance or continue training them. Sometimes they did, but usually they had this negative connotation of trainers. And I remember sitting down with a physical therapist about one of my clients who had had a knee replacement. And she said, “Let me guess, you want to know how much more he can do?”
And I just really felt that:
a) I wasn't trusted
b) sometimes I didn't agree with the recommendations that were given
So at that point, I said, you know:
“I guess it's time for me to go to school for physical therapy so that I can address the entire spectrum. “
So usually when that question comes up, part of my answer is I was a powerlifter first and we work with everybody and injured powerlifters included. But we come from a background of powerlifting and we do physical therapy differently because we incorporate powerlifting and the injured painful lifts into a program.
Dr. Rori Alter, PT, PRSCC, SSC: [00:06:08] Into the rehab process. And I think that's really important what you just said:
We integrate training into the rehab process. And I think that one of the biggest things that I see that physical therapy struggles with, aside from the outdated treatment methods and outcome measures that were required to use with the insurance companies, again, a whole other podcast, why were cash based, physical therapy practice, etc.
But one of the problems that we see and why people continue to get injured after they've had surgery or after they've gone through the physical therapy process is because physical therapy and return to sport or sport training is separated.
And what we do is it's not physical therapy. It's return to sport therapy immediately. As soon as you get injured or as soon as you have surgery or when you're ill or whatnot, we start that process from the get go.
So that I think is one of the distinguishing factors between a person who is a physical therapist who might also train, versus a person who integrates physical therapy and barbell training and powerlifting together.
Dr. Alyssa Haveson, PT, PRSCC, CSCS: [00:07:35] Yeah. So I know we had this conversation the other day.
One of the other things that we were discussing is:
How do we truly combat that negative connotation that powerlifters, or injured powerlifters oftentimes associate with the run of the mill physical therapy clinic.
And how do we as physical therapists combat the negative connotation associated with barbell training, because that's the other side of it.
A lot of times we have medical doctors or even clients who say, well, I don't think I should do this, or a doctor told me I shouldn't do this or it's not safe for me to barbell, train or lift weights because of X, Y or Z. How do we address that?
Dr. Rori Alter, PT, PRSCC, SSC: [00:08:19] Yeah.
So I think the most important thing is by being a triple threat. So walking the walk and talking the talk. So not only are we physical therapists and not only are we powerlifters, but we're also coaches.
And I think that being a barbell training or powerlifting coach is what really integrates the two by having an understanding of the nuts and bolts of what a powerlifting or strength program looks like. I think that is extremely important.
And first, understanding how to work with someone who doesn't have an injury or a medical condition that requires special considerations for training.
So being that coach, in addition to a powerlifter, and in addition to a physical therapist, is what bridges the gap between powerlifting and physical therapy.
So, and this is not to knock someone who's a physical therapist and a powerlifter, but if you don't have the education and the understanding of programming and coaching and what it takes to get someone from A to Z, build strength, what that stress recovery adaptation process looks like, what training fatigue looks like, what technique is (and we have actually have a podcast coming out on this as well - so stay tuned for that, what is technique, what is form, what is form? We'll get into that),
But if you don't have the understanding of all of that stuff, you're not going to bridge the gap between physical therapy and return to sport.
Dr. Rori Alter, PT, PRSCC, SSC: [00:09:47] So what we do here at PRS is we are all three of those things. We understand from the mental, emotional and physical component of being an athlete. And we've had injuries because let's be real. And we talk about this all the time and all of our content with all of our clients that injury prevention is not a thing. Injury risk reduction is what we do.
But if you don't have an understanding of training, fatigue, form, programming, stress, recovery, adaptation, modifying technique, etc., if you don't have an understanding of how injuries happen in barbell training, you're not going to complete the physical therapy process and integrate that return to sport process into physical therapy.
So by being coaches, we can start that from day one of physical therapy.
And if someone comes to us because they've injured themselves through training, we can assess and evaluate their program and we can educate them on how to reduce their risk upon full return to powerlifting. So I think I think I covered everything. Is there anything that I missed there?
Dr. Alyssa Haveson, PT, PRSCC, CSCS: [00:11:09] Actually, Rori, you did miss something.
Let's talk about our training method and how we do this and integrate those three skill sets.
Dr. Rori Alter, PT, PRSCC, SSC: [00:11:19] Sure. Obviously, we should talk about the Sustainable Training Method. That's why we're here to talk about that today. Right. So I'm going to read our in the definition of what the Sustainable Training Method is. We've spent a lot of time over the last three years developing the Sustainable Training Method.
We didn't really coin the term the Sustainable Training Method until a couple of months ago. Yeah, I would say probably like six months ago or we were getting ready to launch. We have three courses that we use to teach coaches, clinicians and athletes about barbell training and powerlifting and our method. But we gave a free masterclass and it was all about Sustainable Training and it had this really long name. And then I was like, let's just call it the Sustainable Training Method.
And that's really when we've been teaching courses and kind of really getting our method out of our brains and onto paper, so to speak, for the last three years since we started teaching our online courses, which has been instrumental in really getting our, our PRS specific terms and ideas and concepts and method, systems, frameworks, etc., out into usable format for other people versus just us and what we know we do.
So we have a written definition of what the Sustainable Training Method is. So I'm just going to read that to you guys. So I don't butcher it because I tend to go on long tangents.
So the PRS Sustainable Training Method, without further ado, is the efficient, minimalistic and systematic application of exercise selection, prescription and fatigue management to support long term goal attainment, motivation and injury risk reduction and strength athletes takes into account unique circumstances of the individual, considers their motivations, which can vary through different points in their life and depending on circumstances they're experiencing, it takes into account. Understanding the client's individual goals and not negating or neglecting their goals.
Dr. Rori Alter, PT, PRSCC, SSC: [00:13:19] And this system gives us the ability to find just the right amount of stress at the right amount of time for the individual. So that's in a nutshell the Sustainable Training Method. And we use this with our healthy athletes and our injured or medically compromised athletes as well.
But by having a system that we can apply to a well athlete and having a system that helps us understand stress, recovery, adaptation, fatigue and how programming and technique play into injury and recovery, we can then apply it to the rehabilitation setting and to the medically compromised or aging or special populations as physical therapists or what we call clinical coaches.
So a clinical coach is, as we define here at Progressive Rehab & Strength, is a rehabilitation professional who is a sport athlete and also coaches that sport.
So our underlying goals here at Progressive Rehab & Strength in the Sustainable Training Method are what drive our decision making process with all of our athletes injured, medically compromised, well, special population, etc. And our four core goals are:
Maximizing strength in muscular development
Reducing injury risk
Optimizing goal attainment
And instilling longevity.
And those four goals drive every decision that we make with every client, no matter what their specific situation is and what their specific goal is.
Alyssa, do you want to kind of dive into what the key features of the Sustainable Training Method are?
Dr. Alyssa Haveson, PT, PRSCC, CSCS: [00:15:14] Yeah, so we've developed this Sustainable Training Method from the core goals and then there are pieces of it that are really important to us, that really make it work.
And some of them are using:
Descriptive rating of perceived exertion (RPE)
Estimated one rep max (e1rm)
And tracking training trends.
So we do a lot of tracking here at PRS for all of our clients and we use the information that we're tracking to assess:
What our clients really need
When they need changes to their program
And we use this to control their fatigue levels and improve performance outcomes.
We also work forward with our programming rather than always working backwards.
So we follow the progress of the client, make changes as they're needed while monitoring their training trends, rating of perceived exertion (RPE) estimated one rep max (e1rm) and like I said, use that information to let the client guide the program so that it fits them where they're at, rather than saying, hey, all right, you're done this block. Let's put it away. And here's your new program because that's not always needed.
Dr. Rori Alter, PT, PRSCC, SSC: [00:16:29] Yeah, I want to just chime in with two things. So, one, how this and we were having a conversation in our student Facebook group the other day about:
How would you describe the Sustainable Training Method? Is it block periodization? Is it linear periodization? Is it linear progression? What is it?
And it's this work forwards approach is really a repeated linear progression, not a linear periodization. Because periodization implies that we're working on specific sport attributes or skill attributes in a particular time frame and then switching those goals at some point.
So we say linear progression for the main lifts because we're just running it out until they can't do it anymore. But not by missing, failing or going backwards. We're using rating of perceived exertion (RPE), estimated one rep max (e1rm), and they're training trends over time.
So we map these things out over time. We keep great training logs on our clients and we're using all that information to help us work forward and make these finely tuned adjustments so that it's a linear progression model for their mean lifts over and over and over and over again.
Then where we take into account this block periodization or periodization model and this is really for the intermediate to advanced lifter, then we can have a whole conversation about novice training which is straight up linear progression, right? Using our system or our method to finely tune things.
But this work forward approach is linear progression for the main lifts, the strength lifts, powerlifts, and then it's either linear periodization or block periodization with auto regulation for the supplemental and accessory lifts.
Dr. Rori Alter, PT, PRSCC, SSC: [00:18:36] So where we work on those different attributes, hypertrophy, volume, accumulation, strength, development, etc., we're doing that mainly in the supplemental and accessory lifts. So it's just the Sustainable Training Method. We can't say it's block periodization, we can't say it's linear periodization or straight up linear progression. It's the PRS Sustainable Training Method.
But I do want to, just before we go into the other features of the method, I want to for anyone who is listening and does not know what rating of perceived exertion (RPE) is or estimated one rep max (e1rm) or what we mean when we're talking about tracking training trends or fine tuning or working forwards or these types of things.
We have many articles on our website that cover exactly what rating a perceived exertion (RPE) is, exactly what estimated one rep max (e1rm) is, and how we use it and how we manage fatigue through training trends. So I just want to pull your attention to our websites, progressiverehabandstrength.com. This little bar at the top, there's a content button. You can click that and you can get access to all of our articles there sorted by programming, injury, technique, etc. and we'll link to the content section on our website in the show notes. So head down to the show notes and click there, or just go to progressiverehabandstrength.com and click the content tab.
So to dive back into the Sustainable Training Method and kind of key features of it, what we find, and this is I think really important for especially the clinician, the rehab clinician and what, how we integrate rehab into the clinical practice is what we call and we've defined as the Repeated Novice Effect.
Dr. Rori Alter, PT, PRSCC, SSC: [00:20:31] And this is extremely important and why it's so important. And Alyssa, we should make a note to just have a conversation in the podcast episodes about novice training, but why it's so important to understand novice training and programming and what the attributes are of that and what that looks like. Because when someone first comes to you as a client and they've never trained, obviously, they're a novice.
And so here's where we get into the Repeated Novice Effect. So someone comes to you, they've never trained straight up novice, someone comes to you, and they've been doing some other type of training, other type of resistance training or just resistance exercise. They have a novice effect again, they have the ability to make gains from being on a novice program.
When someone's injured, we treat their injured area as a novice because of the training that they or even their whole body, depending on how long they've been injured or how ill they are or how how long they've been out, maybe they had surgery and they haven't trained for four or five, six, seven weeks after these layoffs that are kind of more than like two or three weeks, we have what's called the Repeated Novice Effect. You're able to make gains again quickly on a more regular basis than you are later on in your training career, if you've been continuously training for months and years.
Dr. Rori Alter, PT, PRSCC, SSC: [00:21:51] So the Repeated Novice Effect.
So let's just talk about COVID. Everybody who did not have access to a gym for months because of COVID, they didn't have home gym equipment, maybe they had home gym equipment, but it wasn't a barbell and they haven't touched a barbell in six months because of lockdowns.
Sure, they were an advanced lifter before lockdown, but right now when they go back to the gym, they shouldn't jump into an advanced program. They can really benefit and actually probably make more progress than where they were as an advanced lifter before COVID or before that lay off because of the Repeated Novice Effect.
So we use that Repeated Novice Effect very regularly with our clients, especially those coming to us from a clinical perspective. So we will do an episode on that. Absolutely. I think we should just do like a whole episode on the Repeated Novice Effect. So we'll put that down in our notes and come back and probably like somewhere in the 5 to 10 episode range and we'll talk about Repeated Novice Effect.
And then the last feature and I think that this is really important and kind of plays into the Repeated Novice Effect is our Athlete Identity and this we have an article exactly on this as well. So we'll link to the Athlete Identity article as well.
But Alyssa, can you talk about what Athlete Identity is and how we use it?
Dr. Alyssa Haveson, PT, PRSCC, CSCS: [00:23:28] Yeah. So in order to effectively work with someone and program and plan their training, we really need to understand who they are. So Athlete Identity is really important and it's necessary to consider in order to effectively work with someone and coach them and write their program and give them guidance and a program that really works for them.
So when we're thinking about Athlete Identity, you know, a lot of people will say they identify that they're an intermediate lifter or maybe advanced lifter.
The reality of it is, that most people are novices, some are intermediate lifters, and very few are advanced lifters. And, you know, we're looking at that, we're looking at different attributes of the lifter to determine what level they're at.
But when we're considering Athlete Identity, there are four variables that we're looking at. And one is continuity of training. So, you know, if they've been training for five years, but for the last six months weren't consistent or maybe would get into the gym one day a week and then maybe two the next week, even that, where they're really not training frequently enough to keep building and making progress, then their training really isn't that continuous. So when we start with someone, we want to know how long they've been training and how continuous that training has been throughout that time frame.
Dr. Rori Alter, PT, PRSCC, SSC: [00:24:56] So I just want to chime in with an example of continuity of training and talk about different ways that training can be interrupted. So I'm just going to go ahead and use myself as an example because myself. Well, Alyssa, you and I are both I would say, generally speaking, until we talk about the example for me, are advanced lifters. We've been training continuously with very little interruption, even with injuries, minimal interruption from injury probably haven't even taken a full week off in ten years from training.
So then Rori goes ahead and gets pregnant intentionally. Very happy with my little guy. He's so cute. Anyway, got pregnant. Got extremely sick the first 20 weeks of pregnancy. Didn't train for 20 weeks. Literally for the first time in my essentially entire life since I was 12 years old, I didn't train for 20 weeks. Between nausea, losing 8 pounds, dehydration and chronic migraines from my little butthead who still kicks me in the ass. I didn't train for 20 weeks.
So then you have someone whose physiology has completely changed because of me. We're not going to call pregnancy a medical condition, but we can make a comparison to a newly new diagnosis or medical condition, someone who’s ill, whatever, 20 weeks. Physiology has totally changed, but also completely detraine. Obviously there's 10 years of barbell training accumulated and strength development and a lot of muscle mass put on me. So we have that stored in reserves for me.
So we don't go back to ground zero when we take 20 weeks off. But our ability to process that stress recovery adaptation process, our ability to go through that stress recovery adaptation cycle is new again.
Dr. Rori Alter, PT, PRSCC, SSC: [00:27:05] Essentially. So when someone's a novice, they can recover from training very quickly and they can add more stress essentially every time.
When someone on the other end of the spectrum who's advanced, we apply a high amount of stress. It takes us much longer to recover, so it might take us three or four weeks to recover from a high training stress.
So how we apply stress and how frequently, how much and how frequently we apply stress as an advanced lifter is different than in a novice lifter.
So coming back from once, I felt better after those 20 weeks, those 20 weeks of not training, it wouldn't make sense. Also, a novice trainee doesn't need as much volume, does not need as much intensity as an intermediate or advanced lifter. So coming back from 20 weeks of not training because of essentially being sick from pregnancy and also now being 20 weeks pregnant, I should not jump back into what my training schedule training program looked like in terms of frequency, volume and intensity and format that it was before I got pregnant. Right?
So now I can use less volume, less load and more frequency or more regularity of training the same lifts over and over again to build back up my strength to where I was, hopefully.
Obviously, when you get pregnant, you're not going to build back up to where you were. But if the case was different for example someone who came out of COVID after six months, 20 weeks, whatever, and we start with a novice linear progression. Again, somewhere between the eight and 16 week mark you'll be back up to and probably surpass where you were when you stopped. Or maybe even your peak if your peak was not where you were before you stopped. So that's an example.
Dr. Rori Alter, PT, PRSCC, SSC: [00:28:54] So after I started to feel better from being sick the first 20 weeks of pregnancy, I was going to say 20 weeks of training, so many weeks of pregnancy. I then started on a basic novice linear progression and was able to build back up my strength again.
But then obviously the belly got bigger, the fatigue started to set in. I was, you know, then I started to separate my lifts because, you know, then we start making training modifications that I knew how to make that I would be able to make if my self was my client. Because we understand programming and we understand health and wellness and different medical conditions and different attributes of different types of people with different types of considerations.
So I think that's really important when we look at continuity, when we look at the athlete ability, Athlete Identity, sorry, I kind of just covered it all by giving that example. I kind of just covered all the attributes of Athlete Identity where we were just talking about continuity of training.
The only thing I didn't talk about was really athletic abilities, which is the next one. So just to kind of key you into what the four attributes of Athlete Identity are:
Continuity of Training
Athletic Abilities
Medical and injury/history
Recoverability.
So we'll quickly talk about the remainder of the three since we talked about continuity of training already.
Dr. Alyssa Haveson, PT, PRSCC, CSCS: [00:30:30] But I think that's a really good example how you almost included everything in it, because that's really what we're looking at when we're looking at someone and determining their Athlete Identity and really who they are.
We're looking at the big picture and everything you know one factor affects another and it's really all related and it can be hard to talk about one and not the rest of them.
And, you know, in terms of athletic ability, we're when we say athletic ability, we're looking at is somebody a fast learner, a good mover, responding well to cues. Do they adapt well just to having a coach or do they have a little bit more trouble getting the technique down, are cues confusing for them. And really the other big part of this is the rate of progression that they're progressing each lift and how much weight is being added each time.
Dr. Rori Alter, PT, PRSCC, SSC: [00:31:23] So yeah, I just want to interrupt you there because we could think of how much they're adding each time as recoverability. But in the athletic ability sense, it's looking at if someone is a great mover, they were a division one collegiate athlete, they played four sports every season and they were MVP of their whatever, they likely have really good technique and they're great mover and they can take larger jumps because they have very good body awareness.
They're at a lower risk for injury because of how well they move and how well they understand their body versus you have someone who's been like a knitter their whole life and has decided, you know what, it's time to beat this osteopenia. And they come into the gym to work with you. And they don't know their nose from their toes. They have a smoking history as well. And so now you're like, okay, maybe I'm only going to add two and one half pounds per session for their squat instead of 10 pounds per session for their squat because of the way that they move and their body awareness, even though they probably could handle a 10 pound jump, I don't know if their technique or their movement abilities can handle a 10 pound jump. Does that make sense?
Dr. Alyssa Haveson, PT, PRSCC, CSCS: [00:32:54] Yeah. And I think that the other part of that is the first person you talked about is likely lifting more weight to begin with. So those jumps, you know, are not relatively as large for the more athletic person than they are for the person who's been knitting and smoking and wants to take up barbell training. So looking at their athletic ability, that's another part of the athlete identity. And Rori, you really did cover medical or injury history. Aside from, you know, being pregnant, we could consider really anything surgical history, pain history, symptoms.
Dr. Rori Alter, PT, PRSCC, SSC: [00:33:34] Yeah. And I think that the biggest key for medical and injury history and how we tie this into rehabilitation and how we shift our mindset from working with an athlete who is well and we're just coaching them versus working with someone who is injured and either had surgery or is we're dealing with a back pain, back injury or whatever, acute, chronic, whatever we're trying to get out of injured and into well again. Understanding their medical history, their injury history, their medical conditions, or what their current status is health wise helps us determine starting loads rate of progression. It can play into their movement abilities because of range of motion limitations, whether it's a joint at the joint level or at the muscular level, or because they have range of motion restrictions after surgery or whatnot.
Understanding the medical and injury history and regular well person coaching, we can then integrate those two and say, okay, this is where what our starting range is in terms of loading and progression and rep ranges etc.. So that's kind of where that plays into the starting points and rate of progression. I think that medical and injury history is going to have the most influence on that.
Dr. Alyssa Haveson, PT, PRSCC, CSCS: [00:35:06] So when we're talking about Athlete Identity and rehab or physical therapy, working with injured powerlifters or barbell athletes and working with healthy barbell athletes…
Where do these things intersect for us and what we do?
Dr. Rori Alter, PT, PRSCC, SSC: [00:35:26] Well, it's ultimately really a sliding barbell training is a spectrum or a sliding scale that we can use with anyone, essentially, so we can use it with our like I kind of already mentioned this, but it's really a sliding scale.
So there really is no difference between programming for a well person or an athlete versus someone who's injured or has a medical consideration that needs to be considered when we're coaching them or rehabilitating them. It's really this sliding scale or spectrum that we can use with post-op clients, people in extreme pain, or people with long standing illness or highly competitive athletes who don't have injuries.
So I think that's important to understand where the intersection of rehab and barbell resistance training are, but also understanding that Repeated Novice Effect and applying it to the lowest level.
So when someone has an injury, we're not going to just like I mean, we might just modify their program just a little bit. Maybe it's just we give them a box squat and say, lower the load, change the range of motion and keep training, and then we'll progress from there.
Or maybe they do have to take two weeks. I mean, there's so many scenarios that someone could go through and we're going to obviously, take the Athlete Identity and the situation and say, what do we modify? How do we modify it and do we take time off or do we not take time off? But we can really utilize that Repeated Novice Effect on the lowest level. So after acute or chronic illness, acute or chronic injury, we can say, okay, let's backtrack. Someone's had a knee replacement, for example. So they obviously haven't been training at full capacity for some time because of the knee situation that led them to get a knee replacement.
Dr. Rori Alter, PT, PRSCC, SSC: [00:37:23] Then they have the surgery. They are in the hospital for a few days, then they go to subacute or acute rehab for a week, then they're home and then they start outpatient physical therapy. But they're not walking as much. They're not training their upper body because they've obviously been in the hospital or in rehab or whatnot. So then their whole body goes through a change, not just their knee or their leg, right?
So we can apply this repeated novice effect to their whole body because they probably took somewhere between four and 6 to 8 weeks off there. At least their upper body training and their whole lower body physiology has changed. So we're going to apply the repeated novice aspect to their lower body as well with modifications due to the surgery that they had.
So we can also do this with someone who might have experienced some type of illness. Maybe they've gone through chemotherapy and now they're ready to start or they're in chemotherapy and they are still training. You know, we can apply these things to that type of person on their level that accounts for their physiology and their athlete identity.
So really just having an understanding of how things work when someone is totally healthy and able and having a really deep understanding of the mechanics and the programming and stress recovery adaptation and fatigue as well as their medical conditions, physiology, etc., and then modifying those things in order to meet the person where they're at in terms of their health and ability. So this is really how we kind of intersect and combine rehab and barbell training as a clinical coach and not just a physical therapist or not just a barbell training or powerlifting coach.
Dr. Alyssa Haveson, PT, PRSCC, CSCS: [00:39:29] So I love what we do, obviously, and I love how we do it. And when I went to school for physical therapy, my goal was to be doing exactly this. I never really had any intentions of working in the run of the mill clinic, but because it's harder to do what we do in that setting.
So one of the common questions that we get from physical therapists is how do they do this at a mill model practice when they're potentially going to get pushed back from the clinic or they don't have all of the right equipment?
How do they do what we do and really, you know, provide the best possible care and treatment and then some to their patients or clients?
Dr. Rori Alter, PT, PRSCC, SSC: [00:40:17] Oh, I love that question. And I think it is really one of the most common questions we get, and that's actually why we started our courses because I would just get DMS from people who wanted to intern with me or pick my brain about how I started Progressive Rehab & Strength.
How do they deal with the mill model physical therapy practice?
How do they deal with the crap that we're taught in physical therapy school that's so outdated that we just have to know for the licensing exam and all that stuff?
And at the end of the day, you just gotta get through school. If you want to be a physical therapist, you just gotta take the licensing exam. And also having an understanding of all that stuff I think is beneficial because if you understand how those things work and what the research is, you can help change the field of physical therapy first and foremost, and you can also help people change their views of physical therapy.
When someone comes to you to say, “Oh, like the last time I went to physical therapy, they gave me the hot pack and steam and massage, and then I felt better,” you know, but then like a week later, you still have the same problem, you know? So first and foremost, we have a couple of things for you and we'll be talking about this in our next episode.
Dr. Rori Alter, PT, PRSCC, SSC: [00:41:33] So definitely come back to our next episode and you can also download what's called what we call the Clinical Coach Starter Kit. So that is going to be linked in our show notes as well for you, it really covers the different scenarios that you might be in as a newer clinician who isn't yet working for yourself or doesn't really work in the environment that you want to be working in, whether you're a chiropractor or physical therapist, we we don't exclude chiropractors.
Actually, a lot of our online course students have been chiropractors. So you guys are in the same situation as we are as physical therapists. So the Clinical Coach Starter Kit and that's why we don't call ourselves the physical therapy coaches or clinical coaches because the background that physical therapy, physical therapists and chiropractors have is very similar in terms of the rehabilitation process. If you are more modern in your thinking.
So whether you're in a mill model physical therapy practice, who doesn't have the equipment that you might think you need to rehabilitate a powerlifter or work with barbell training athletes or whatnot.
Dr. Rori Alter, PT, PRSCC, SSC: [00:42:41] It gives you the kind of like a script of how to approach any pushback that you might have from your bosses or management in a mill model physical therapy practice and what equipment you can use that's available to you that you might think is not going to help integrate barbell training and rehabilitation, but you can still use those lighter implements or things that are not barbells to implement the principles of barbell training, which is why it's very important to also be a coach and understand exercise prescription, which is not something that they teach in school. They expect your clinics to teach it to you, but if your clinic doesn't really value exercise or use exercise or it's like if it's the little high school aides that are applying the exercise prescription, you're not going to learn anything in your clinical rotations from that.
So our Clinical Coach Starter Kit covers working in a mill model physical therapy and what equipment you can use or ask for in a small, tight space or and how you can approach management about push if you have any pushback or if you are ready or want to venture out on your own. What to look for in the gym spaces that you might be renting from and what equipment you might need to buy to add to it.
Dr. Rori Alter, PT, PRSCC, SSC: [00:43:59] If they don't have it, something like a 15 pound aluminum training bar might be something that you want in there. So hint, hint, go download the Clinical Coach Starter Kit because it will give you a list. And then I think the last scenario is, okay, so you're ready to open your own small space.
What do you need to be a clinical coach using a similar or the same model as the PRS Sustainable Training Method and how do we do that as coaches?
So that's in the Clinical Coach Starter Kit. You can find that linked in the show notes. Or if you go to our website, there is the content tab and then there's free downloads or it's not free downloads, it's ebooks. We've got ebooks on there. So that is definitely what you want to check out.
If you are interested in this, you can also get on our waitlist for our courses. We open up our Programming Fundamentals course once a year, our Barbell Coaching & Movement Optimization course also one time of year, and our Business Best Practice for Clinical Coaches one time a year as well. So definitely get on the waiting list if that's something you're interested in. But first and foremost, download the Clinical Coach Starter Kit.
Dr. Alyssa Haveson, PT, PRSCC, CSCS: [00:45:12] There's one more very common question that we get asked related to this topic, and it's coming from the injured powerlifters.
And they often want to know how to find physical therapists, clinical coaches like us when they're injured, how do they find those who are like us or work with us, especially when they're not nearby, whether they're on the other side of the US or in another country, how do they reach us?
Dr. Rori Alter, PT, PRSCC, SSC: [00:45:44] Sure. So we have been in the remote rehab or telemedicine space since 2015. So we offer remote rehab coaching, tele physical therapy and remote barbell coaching and remote powerlifting coaching. And also we remotely work with pregnant lifters and postpartum and anyone who's experiencing any pelvic health issues in physical therapy. Pelvic health issues in barbell training.
So we offer free consultations. So we have different services that might be right for you or might not be right. So we want to make sure that we're a good fit before we work with you. So definitely we'll put the link in the show notes as well to book a free consultation with us. We have in-person services in New York and Pennsylvania and we also do remote rehab and remote coaching as well. So definitely if you're interested in working with a clinical coach, there's four of us at press. You can book a free consultation.
But then also we do have a list of students. So coaches and clinicians. So not just not just clinicians, but people who are just isolated. As coaches, we have a list of students who have gone through the press courses on our website as well. So if you're interested in working with either a coach or a clinical coach in person, there might be someone who's more local to you.
Dr. Rori Alter, PT, PRSCC, SSC: [00:47:19] So we're in New York and Pennsylvania, see people out of our home gyms. And again, there are some people who have completed the PRS clinical coach credential and the coaching certification, and those people are listed on our website as well. So you can check out our website to see if they would be a good fit or you can book a free call with us.
So I think that covers everything that we wanted to talk about and episode one of the Progressive Rehab & Strength Podcast.
So we thank you guys so much for joining us on our journey. We really look forward to more episodes with you guys and if there are any questions that you have that you want us to answer on the podcast or any guests that you want us to have on the podcast, please submit a form that's linked in the show notes as well. You can fill it out with your questions as many times as you want. We absolutely love creating content that comes from you guys. It's more about you than about us. Everything that we do has come because of you guys. So drop your questions into that PRS podcast question form, which is linked in the show notes below. And we look forward to seeing you next time. Bye for now.