Healthy Wealthy & Smart

Healthy Wealthy & Smart: Where Healthcare Meets Business. The Healthy Wealthy & Smart podcast, hosted by world-renowned physical therapist Dr. Karen Litzy, offers a wealth of knowledge and expertise to help healthcare and fitness professionals take their careers to the next level. With its perfect blend of clinical skills and business acumen, this podcast is a one-stop-shop for anyone looking to gain a competitive edge in today's rapidly evolving healthcare landscape. Dr. Litzy's dynamic approach to hosting combines practical clinical insights with expert business advice, making the Healthy Wealthy & Smart podcast the go-to resource for ambitious professionals seeking to excel in their fields. Each episode features a thought-provoking conversation with a leading industry expert, offering listeners unique insights and actionable strategies to optimize their practices and boost their bottom line. Whether you're a seasoned healthcare professional looking to expand your skill set, or an up-and-coming fitness expert seeking to establish your brand, the Healthy Wealthy & Smart podcast has something for everyone. From expert advice on marketing and branding to in-depth discussions on the latest clinical research and techniques, this podcast is your essential guide to achieving success in today's competitive healthcare landscape. So if you're ready to take your career to the next level, tune in to the Healthy Wealthy & Smart podcast with Dr. Karen Litzy and discover the insights, strategies, and inspiration you need to thrive in today's fast-paced world of healthcare and fitness.
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Now displaying: March, 2019
Mar 30, 2019

On this episode of the Healthy Wealthy and Smart Podcast, Shannon Sepulveda guest hosts and interviews Nikki Kimball on her experiences as a female distance runner.  Nikki Kimball is an American distance runner specializing in the Ultramarathon. She is also a physical therapist in Bozeman, Montana.

In this episode, we discuss:

-Nikki’s journey to becoming a long-distance running athlete

-The societal health and wellness ramifications of running

-How Nikki’s experience as a physical therapist has shaped her running journey

-Gender differences, both physical and financial, in competitive running

-And so much more!



Shannon Sepulveda Website

Shannon Sepulveda Facebook


Trail Sisters

Nikki Kimball Instagram



For more information on Nikki:

Nikki Kimball (born May 23, 1971) is an American distance runner specializing in the Ultramarathon. She ran her first 100-mile race at the Western States 100 Mile Endurance Run in 2004, and was the female winner. She was the winning female at Western States again in 2006 and 2007, becoming only the third woman to win Western States three times. In 2014, she won the Marathon Des Sables multi-stage endurance race on her first attempt. Prior to running, her main sport was cross-country skiing. She was crewed at the 2007 Western States by U.S. Senator Max Baucus of Montana, where Kimball lives. She lives in Bozeman, Montana.

For more information on Shannon:

Shannon Sepulveda, DPT, M.Ed., CSCS, WCS is the owner and Physical Therapist at Shannon Sepulveda, DPT, PLLC. She is an Orthopedic and Women's Health Physical Therapist and is currently the only Board-Certified Women's Health Physical Therapist (WCS) in Montana. Shannon received her undergraduate degree from Dartmouth College, Masters in Education from Harvard University (M.Ed.) and Doctorate of Physical Therapy (DPT) from the University of Montana. She is also a Certified Strength and Conditioning Specialist (CSCS). She has been a practicing Physical Therapist in Bozeman, Montana for over 6 years. In her free time, she enjoys running, biking, skiing, hunting and spending time with her husband, son and daughter.


Read the full transcript below:

Shannon Sepulveda:      00:00:00           Hello and welcome to the Healthy, Wealthy and Smart Podcast. I am your guest host, Shannon Sepulveda, and I am here with Nikki Kimball. Hi Nikki. So Nikki, can you tell us a bit about you and what you do?

Nikki Kimball:                                        What I do? My favorite subject, I am a physical therapist here in Bozeman and I also coach running, ultra marathon running. And I got into that because I've been an ultra marathon race or professional racer for almost two decades. And that's kind of what I do.

Shannon Sepulveda:                              So in the ultra marathon running world, when you say Nikki Kimball, people are like, oh, Nikki Kimball. And I feel like, so Nikki is a very accomplished ultra marathoner for those of you who don't know who Nikki is. So we are very, very fortunate to have her here on the podcast. So how did you get into ultra running? Because back then it seemed like it's not as popular as it is now.

Nikki Kimball:                00:01:01           No, I don't think it is, but there were still, you know, a boatload of us. I mean there are thousands of us who absolutely loved this sport and we, you know, there wasn't much money at it or anything like that. It wasn't very popular. But I think a lot of cross country skiers come into it sort of organically because of the training we do for cross country skiing is essentially ultra marathon training, which is kind of funny because the women don't get to race very far. The longest they can do is 30K at the Olympics. It's pretty pathetic. But regardless, we always trained with the guys anyway. So we would do these four or five hour run hike things in the woods. And so it was kind of doing it anyway.

Nikki Kimball:                00:01:50           And in graduate school I raced a lot of 5K's, 10K's, half marathons, marathons, just kind of wherever. Cause I had a store team that sponsored me and they'd pay all my race entry fees. And so I just go do fun things. And it just like sort of saved me through Grad school because it had gave me this other thing besides studying all the time. And it made me sort of mentally clearer. I just loved it and I'm just like running makes me happy. It just makes sense to go out and run and run and run. And so yeah, at the time it wasn't super, it wasn't mainstream popular, but those of us who did it loved it. Did it all the time.

Shannon Sepulveda:                              So you grew up Nordic skiing?

Nikki Kimball:                00:02:41           Yes, in high school. I grew up in a town called Chittenden in Vermont, so south central Vermont town and I grew up skiing. My brother was four years older, so he was skier and the Bill Koch Youth Ski League is this big, big thing then. I don't know if it still is, but there would be these races for kids and because I mean the kids who would be racing, you know, from eight years old on, they kind of knew what they were doing, but they had to do something for like the little brothers and sisters. So they'd have these races, they called Lollipop races because you get a lollipop at the end and you might go 100 meters maybe holding your parent's hand. But I believe I was three when I first did this. I basically learned how to ski and walk at the same time, I'm sure.

Nikki Kimball:                00:03:31           And so yeah, I mean I just don't remember life without competition, without endurance sports.

Shannon Sepulveda:                              And then did you race in college?

Nikki Kimball:                                        And I raced at Williams College, so all four years, so division one racing. Then, partway through college I decided to switch to biathlon. So my senior year I had to keep my rifle at a professor's house cause they weren't too keen on having rifles on campus. And so I raced a couple of years in biathlon hoping for the ‘98 Olympics and I raced through ‘94.

Shannon Sepulveda:                              Oh Wow. So how is biathlon different from cross country skiing, like endurance wise. What do you think?

Nikki Kimball:                                        Similar, really similar. I mean, it's just adding this sort of cognitive piece to it. I mean to go from skiing as hard as you can to shooting clean for five rounds is, it just requires a whole different skillset.

Nikki Kimball:                00:04:37           Of patience and humility and cognition. I mean, looking at where the wind is and deciding you know, how to change your sites on your rifle, by this, you know, it's just an extra layer. And I loved that.

Shannon Sepulveda:                              Do you feel like that has influenced your ultra racing at all? Like part of it?

Nikki Kimball:                                        Probably not a ton. I mean, I think the calmness needed to do well in biathlon in the humility is super helpful. So those two things are good because if you're racing a hundred miles, something is going to go wrong and running. You don't have perfect races when you're beyond 20 hours, you just don't. And so having, you know, biathlon does teach a bit of that, sort of humility but also ability to change with the changing situation. You might come into the range and the wind's coming from a completely different direction than it was when you, when you cited your rifle in and you have to deal with that.

Nikki Kimball:                00:05:48           And similarly, an ultra marathon is very common that you come into an aid station and the bag of stuff that you wanted there isn't, or your crew isn't there or something that you expect isn't there. And so that ability to think during the race and make changes to your plan during the race is definitely something is common between the ultra running and biathlon.

Shannon Sepulveda:                              Cool. So then when you say graduate school, do you mean physical therapy? And so how did you get into running, cause it sounds like that's where the transition went into ultra running, is that right? Or where the transition to competitive running?

Nikki Kimball:                                        Yeah, absolutely. Because I threw 94, I was ski racer, which is sort of a different body type also, more muscular and a lot more upper body mass.  So, you know, through 94, ski racing was the only thing I really wanted to do. And I also was kind of I hadn't raced anything long in running, so I wasn't very, and I wasn't good.

Nikki Kimball:                00:06:57           I was fantastic for the middle of the back. I hadn't really realized that I had any ability in running because my abilities not in running, it's in enduring. I always qualified for nationals in D1 skiing. And there was definitely something I wasn't good at. Actually in 94, after a really successful year of biathlon doing well at Olympic trials, I wasn't expecting to make the team because I can shoot very well. Did very well at nationals. And then I ended up getting very sick with depression, losing about 20 pounds and I couldn't even run three miles. Like I couldn't, I couldn't do anything.

Nikki Kimball:                00:07:55           I was just sleeping. All I did. And when I went to Grad School, I came in with a completely different body. I mean I lost all my muscle, and really  I was in Philadelphia, so I'm like, well, what can I do? So running was the thing I could do and this was way before most psychiatrists and counselors were thinking that exercise was important for running. But I sort of knew it, you know, I just knew that I could think better, I could function better, all of those things, everything better when I'm exercising. And so it was sort of natural for me to just my daily dose of endorphins that is just critical to me. Even having normal brain function. It would be like I'd have to run an hour a day just to stay sane.

Nikki Kimball:                00:08:49           So then I went to graduate school and I'm in Philadelphia and I go and do this 5K race and I win it, and I'm like, what the heck? I am not a runner. This is crazy. And then the store team picks me up and then we just started running longer and longer and more and more trails and you know, so it wasn't something I never set out to be a good ultra marathon runner. It just sort of, it just was what I did anyway. And then I realized it was a support.

Shannon Sepulveda:                              Yeah. That's really cool story. Awesome. So what was ultra running like when you started and how is it different now? Cause I mean, how long ago was that when you started?

Nikki Kimball:                00:09:38           I started in ‘99, 20 years ago. It was still very, very competitive at the top.  But the fields were not as deep. And there wasn't, you know, it was never talked about in runner's world, I don't think runner's world even knew what ultra running really was. And it didn't really need to create a magazine, but it was like runner's world is for sort of mainstream runners and getting people into running and it's fantastic for that. But ultra running was never something that would even be considered in, you know, for their audience. And I think that's really telling now. They know now they talk about ultra running and that kind of stuff. And ultra running is now becoming appealing to your general public. It’s just not something that's freaky anymore because it's in the running media.

Nikki Kimball:                00:10:32           Part of me wants to go back to the old ways where you raced and you had only water at the aid station.  The aid stations might be two hours apart and you want a belt buckle after you set a world record you know, it was great. Not that I ever set any world records, but, that's the trail runner part of me. But that was kind of Nice. It wasn't very commercial.  And now it is more so, but I'm also part of that. I mean I was in films about running several films about running. I was promoting, you know, Nike northface Hoko, which ever sponsor I had at the time. And  you know, kind of using my running to promote basic health and fitness things. And you know, I mean it just, I mean I definitely was heavily involved in media surrounding running, so the increase of popularity of running, I'm not innocent in that.

Shannon Sepulveda:                              I think it's awesome. I think it's really great because not everybody's going to be fast at a 5K and some people are really good. It's completely different. Being fast at a 5K is completely different than running a hundred miles. Yeah, it's totally different. And some people are really good at it and some people are not. And some people, the accomplishment of running just running 50 miles or 18 miles or whatever, will get them through, get them on a high for a whole year. I mean, the fact that they can do that. So I think that's amazing.

Nikki Kimball:                00:11:54           And it'll get them training for a whole year. Will get them healthier in an age in which sedentary lifestyles our biggest killer, or contributes to it anyway. We really need to make sports mainstream and running is so easy and it's something we don't need special equipment for, you can do it on any budget. And then you can still compete in it.

Shannon Sepulveda:                              But I mean, it's like if you were a baseball player, you can't just go play baseball games a lot of the time. But if you're a runner, you can always say, I'm going to sign up for x race and train for x race.

Nikki Kimball:                00:12:49           Yes. And so it’s the perfect lifestyle, lifetime sport and you can do it if you're running, you know, if you're running team, if you, let's say you want to do stuff with people, you're running team doesn't show up for a workout. You can do that work out on your own. You know, it can be as social or isolated as you want to be. And I think runners know that, you know, sometimes, you know, you and I are both physical therapists. Sometimes we have a whole day of patients. We want to go out and run the five, 10 whatever miles by ourselves because we're just, we need that break and not talk.  And then other times, you know, you want to go out with a group of 10 people and just, you know, just chat the whole way.

Nikki Kimball:                00:13:40           And I swear that if political leaders could do all of their work while running, things would actually work. I mean, cause I swear every, you know, every long run you go on, somebody comes up with an idea that just seems brilliant.

Shannon Sepulveda:                              Yeah. And you get to talk to people who believe different things and have actual conversations with people because there's nothing else to do, right. You're out in the woods for four hours and that's who you're with and you can talk about stuff and you're not checking your phone. And now I think it's great.

Nikki Kimball:                                        Yeah. And it's something that's so foreign to us in modern times. You know, we're always sort of plugged in and we're always hanging out with only others like us and running sort of takes all that away. Yeah, I really liked that.

Shannon Sepulveda:                              And I think, you know, even, you know when I get postpartum women in here and they want to run a 5K after they've had a baby and they're like, well I'm not really a competitive runner.

Nikki Kimball:                00:14:37           I just, I really want to run this 5K. And I'm like, that is awesome. I really want to run it in under 30 minutes. Well that's such a great goal. Like let's do that and it's attainable and it's great. It gives people a goal of something to do.  It doesn't have to be 100 miles, you know, like it doesn't, that’s the beautiful thing about running.

Nikki Kimball:                                        And I love about ultra and running in general is that different variations on running are becoming popular. Whether it's spartan racing or color runs or you know, like none of those events is going to attract every person, but it's going to attract somebody. And if somebody gets hooked because they like having paint balls thrown at them, like great, if that keeps that person from getting type two diabetes, I mean it's the cheapest medicine we can buy.

Shannon Sepulveda:                              Oh yeah. And I think that that's why it's so awesome being a physical therapist because we know how important exercise is and getting people back to that. So like they don't die and they don't get type two diabetes and they don't get heart disease.

Nikki Kimball:                00:16:01           And we're not rehabbing their total knee replacements because of obesity. You know? I mean they have a total knee replacements because they earned it.

Shannon Sepulveda:                              Yeah. I think it's so great just to be able to have, you know, running become more mainstream so it's more accepted and people are really excited about it. I mean, when you go to marathons and you see people of all shapes and sizes completing marathons, I think it's so cool and it's so different from what it was 20 years ago.

Nikki Kimball:                                        Absolutely. Absolutely. I mean, marathons didn't kind of include, they certainly didn't encourage and often didn't allow people to finish a marathon in six hours or more. And now we've got that in there just has to be a place in athletics for all adults because if this is the way we are going to stay healthy in a world that is more and more sedentary, then we need to make it fun because otherwise it's not going to be sustainable for most people. And you know, and we also need to have resources out there for people to do these sports.

Nikki Kimball:                00:16:56           And I just keep seeing more and more emphasis on building trails and on making shoulders on roads so that people can safely bike or run or whatever. I think the more these sports grow, the more people demand from their local government that we have trails, that we have safe places to work out. And play and do all those things that are just going to save us money in the end because we're all healthier.

Shannon Sepulveda:                              Yeah. No, I think it's great. So let's talk about how has being a physical therapist impacted your career?

Nikki Kimball:                                        Probably for the better and for worse. We over analyze everything exactly. I mean, and I'm sure you remember when your first a physical therapist and you're working in general orthopedics and you see people coming in and they're in their sixties and that's old to you because you're in your 20s and you're like, oh my gosh.

Nikki Kimball:                00:17:50           I have all these things that are going to happen to me. Yeah. So you start getting these ideas of things that happen with aging. So that's a little, that's actually probably good, a little cautionary tale there, but, for the first 18 years of my ultra running career, I never missed significant time from races, from any running injury. I mean, the races that I missed were mostly from direct trauma cause I fell off something or trail running is a little aggressive. And I also mountain bike and dirt bike and ski race and do all that. So you know, I definitely have had injuries, but they're usually direct trauma, not repetitive trauma. And I think PT has been the biggest factor in that. I mean also I just have good genetics. Having treated every running injury there is, I could see when one was coming up and I think that helped a lot.

Nikki Kimball:                00:18:44           Oh, I've got this little thing, Ooh, that's not just muscle soreness. That sounds more like, you know, it band and Oh, maybe I should have somebody look and see if my hip is strong or if I’m overstriding or whatever. And so I think, you know, running is a huge deal and running and prevention of an injury is so much more important than fixing it. And PT has given me the patience for that, you know, like, okay, I know I need to take a week and be water running now because I've worked with so many people who didn't do that and now they're out for four or five months.

Shannon Sepulveda:                              Do you see differences in injuries between ultra runners and like your recreational 5K’er?

Nikki Kimball:                00:19:35           Yes and no.  Your recreational 5K’er often it's their first year running and they're much more likely to get injured and injuries that are completely preventable. Just because they just sort of get into it without any guidance. Ultra runners first of all, probably have the genetics that allow them to run that long. So they're probably mechanically more, more ready to run ultras. And then some of the ultra running injuries we see are just like, they can be really serious because we can I think once we're out there racing, to be successful, you have to be able to put pain in a little box or just sort of deflect it. And you really don't, like when I was racing, I really didn't feel pain so much cause I could just sort of play in my head with it. And so you can get people who in ultra running who will go into a race with a stress fracture and it becomes a frank fracture.

Nikki Kimball:                00:20:35           And I've seen that with several ultra runners and you know, that's not your recreational 5K runner might get a stress fracture, but they'll probably actually going to go seek help while it's still a stress fracture and not going to let the bone actually break in half. So sometimes runners, ultra runners can be a little, aren't good at using pain as a guide. I think your recreational 5K runners going to come into when their knee starts hurting or their ankle starts hurting and they're gonna be like, Hey, something's funky here. And so I think those recreational 5K runners are much more likely to get injured, but their injury is also going to be much easier to manage. And ultra runners were all, I mean, most of us I think are addict to the sport and to running and to exercise. And you know, I just know how tempted I am to run if injured, you know, cause I have to work out or I'm just staring at the wall being brain dead. I mean, I really like without you know, at least a few times a week infusion of endorphins I don't function and I think a lot of our ultra runners are that way and we can so we basically go until something's really bad.

Shannon Sepulveda:      00:21:51           So I'm always interested in like the mental aspect of pain.So when you were like racing in your, you know, cross country racing biathlon you're like super anaerobic, like you gotta get over that governor in your head that says slow down. So that sort of mental capacity for pain versus I'm on Mile 90, I have pain everywhere. It seems like a different type of pain. Do you classify those as a different type of pain in your head or are they kind of the same?

Nikki Kimball:                00:22:20           I think in my head they're the same or similar. In ski racing I could always say, or in biathlon, well I'm going to lie down at the end of this kilometer to take a bunch of shots. So you know, you know that that pain is, is there, but I think I dealt with it mentally by, it's going to be over very quickly and it always was. So in that it's somewhat different but so in ultra running you have less intense pains but for a lot longer period of time. And so I don't get to say, oh well it's going to be over soon because this, now you have another four hours left. And I think that got me to the point where I would think of pain as this is just this neural sensation.

Nikki Kimball:                00:23:09           It's nothing more than that. There is no reason to put any emotion into this sensation that's coming in. I mean, I think part of what gives pain its power is fear of pain. And in an ultrathon you have long enough to think that you have to deal with pain in a different way. And if I can just take the power away by saying, okay, I have a nerve signal telling me that my hip hurts or my knee hurts. But that's all it is. It's just a neural signal. And because I think the anesthetic effect of our chemical changes when we run, we can do it. I mean I don't think I'm really tough about pain. Like if it's just, if we're just sitting here and you know, somebody hits me, it's going to hurt just as much, but while I'm running I can take so much more.

Nikki Kimball:                00:24:04           And as long as you don't fear it, it's just way, way easier to tolerate.

Shannon Sepulveda:                              It's so interesting cause it's like when I hear you talk, there's such similarities to chronic pain and like what we know about chronic pain and how as like PTs we treat chronic pain where it's like, you know, these are just neural sensations coming in. The brain controls where you are, what you're doing. Do I need to get out of here? You know, and how we gradually increase people's exposure to certain things to get them out of chronic pain. So when I hear you talk, that's like exactly what I think of. Like you think about it as a neural sensation, not, you know, this emotional response that you have to like give into.

Nikki Kimball:                                        Right, right. And you know, I think that ultra running can be a very good metaphor for life in many ways.

Nikki Kimball:                00:24:57           And that's one of the ways, and I think that medicine, both physical medicine, physical therapy plus medicine, human medicine are starting to research ultra running, which is incredible. And I think, I think we need to look at things like ultra running for managing chronic pain. We need to look at ultra running to see. But I think we need to do more and more research to find like what is it that benefiting here? I think it would be extraordinarily hard to thrive through chronic pain. I mean, we've both worked with so many people with chronic pain and it's really, really horrible. But if you can, you know, do you just give up? I mean there's no, we don't have like a pill form now, we don't have anything that will just kind of get rid of it right away.

Nikki Kimball:                00:25:56           Nothing. And so we have to be able to manage it. And I think ultra running is about managing stuff and so maybe somebody in medicine finds out what, you know, what factors allow us to thrive despite that pain, to win the race despite the pain that we're in. And certainly there's a lot of research out there on mental health. What is it, you know, we know there is, you know, six or eight different things that were changing when we're running that might affect our cognition and mental state. Like, you know, what is it we don't really know. But we know something about running is lessening the effects of depression and other mental illnesses and we know that is lessening the effects of some pains.

Nikki Kimball:                00:26:44           So it's just this brilliant area of untapped research or a research opportunity. I mean, there's so much out there and it's very much in its infancy. But you are seeing people being serious about running medicine now.

Shannon Sepulveda:                              Yeah. It's really interesting when I hear you say manage the pain because that's like when I have conversations with my patients that have had chronic pain for years. I have a conversation of like, this is chronic, we are going to manage it. You're going to have flare ups and you're going to manage it and it's gonna get better. But at some point you're going to have a flare up and it's going to be okay. And so when you think about managing versus curing, it's, I guess very similar to ultra running like it is, I'm in mile 80, I'm going to manage this, right, because I've got to finish it and it's going to flare up and I'm going to manage it and it's going to get better.

Nikki Kimball:                00:27:37           Yes, exactly. And I think this is where all types of medicine need to come together. I mean it's neuro, psych, it's mechanics, it's all of those things. Because how else are we going to let people live quality lives with chronic pain or mental illness, any of those kinds of things. And ultra running is sort of microcosm and like, it's like, yeah, like your whole, you know, it's like a lifetime. And, you know, 100 mile race. And so I think there are really important pieces of information in there that can be applied to our world in general.

Shannon Sepulveda:                              Yeah. That's so interesting. Okay. So the next thing I want to talk about is gender equity in ultra running are running in general. Both prize money, sponsorship, but also physiologically. So which one do you want to start with first? So to just talk about it, because I know you're a very good advocate for women and gender equity and this is a problem in many sports. So let's talk about the problem in ultra running.

Nikki Kimball:                00:28:52           It is, it is a problem and in many sports. I must say on the good side, just to start this out on a good note the changes through my lifetime and how women are treated in sport has been amazing. I mean, when I started racing in the 70s, you know, there were oftentimes, you know, races just for men or you know, the men would get prize money and the women wouldn't get any. And that was really, really common. We just sort of expected that.

Nikki Kimball:                00:29:42           And you know, all through high school and college, and this still happens unfortunately, you know, being a high level ski racer, the women, we would race 5K when the men would race 10K and you know, that stuff is still happening but getting better hopefully sometimes that's changing. And sometime in the 2000 odd you just really stopped seeing prize money be different. Because  prize money is so transparent and you know, there were still a few holdout races that would prize the men and wouldn't prize the women. And in Europe that was very common, which is kind of shocking to me. But many, many races, money for the men and you know, something cute for the women and the fights for gender equity already had enough traction behind them to finally, to really call out race directors who didn't prize equally.

Nikki Kimball:                00:30:52           And with the Internet and with everything being freely, with being able to get that information really easily from your computer, race directors would look really, really horrible at this point if they weren't prizing equally. And so the last 15 years has been pretty good that way. Then we have sponsorship. And most of our contracts tell us we aren't supposed to talk about how much we're getting paid. And that's a brilliant strategy by the marketing people for, on these big companies that sponsor runners because why pay a woman what she's worth when you can pay 12 times less? And that's not an unreasonable that actually I have seen that in order of magnitude difference between males and females, why pay or that isn't, you know, if your customers, when they go to buy that jacket, don't know that, you know, Sarah gets paid 5,000 a year and Joe gets paid 10,000 or a hundred thousand a year, why would we, you know, why would they pay that?

Nikki Kimball:                00:32:00           And I think that's the next area to go or to get down, get down to and really dig into hopefully the last one. There's still other subtle forms of sexism that happened, but this is still a major, major form of sexism that's happening. And I've thought through my professional career and then once I started trying to add up how much I would have made if I'd done the same thing as I did but be a male. And once I realized that I would probably have an extra house in the most expensive part of town, I decided to stop torturing myself. And so some sort of transparency there has to happen. But the other, the subtle stuff, some athlete contracts give you bonuses for getting their logo in print media or on television or all those things will still look through the sports pages in any local paper.

Nikki Kimball:                00:32:58           And they're still often, you know, eight pictures of men compared to one picture of a woman. Or, you know, even if it's two men to each woman in the sports pages, that's money we're not getting because you know, you're not in the picture. I won the race. But the guy's winner gets in there and you still look at Wikipedia. If you look up Wikipedia or any of those race sites or running sites. They'll often have, you know, they'll talk about a race and they'll say, you know, the course record is held by, and it's always the guy. I also have the course record, right. But so then again, the men gets so much more promotion from media and all of that.

Nikki Kimball:                00:33:46           And then that gets the sponsor's thinking that they have a better return on investment from the men because the men are like, look, here's what you know, here are all the newspaper articles I was in, magazine articles I was in. So those more subtle types of sexism are harder to fight. And I think some of us are doing it. Gina Lucrezi is an ultra runner and very solid alternative, but also really great supporter of women's ultra running and has started a company called trail sisters that is huge and just getting bigger and bigger and it is to address some of these issues and also address other physiological issues that women have to fight, have to face. These things are happening. It's just not as fast as I'd like.

Shannon Sepulveda:      00:34:41           I know it's so hard. I mean, I feel like the same thing happens even with like small companies and like they've just had to like fight tooth and now just to even like get, you know, compared to Nike or something like that, just even get themselves and they're a running company for women, but, no matter what it seems like we're fighting an uphill battle.

Nikki Kimball:                                        Yes, we are. And you know, I remember it just a few years ago, I had a couple of women runners I was treating and I was like, Oh, you know, we get into the talk about sponsorship money. And I'm like, well, they've got to be doing better than I did. And you know, both of them were like, yeah, we're about 25% of what the men were.

Nikki Kimball:                00:35:29           I'm like, well, that's better than I did at my worst. At least they're not getting one 10th, but yet again, it's still, it's not okay.

Shannon Sepulveda:                              It's not. Okay. And so what do you think we can do?

Nikki Kimball:                                        I think we talk, we keep open dialogue. We support people like Gina who have trail sisters. We support brands like Oiselle who are trying to make a difference. And I think that each of us you know, each female athlete is one cog in the machine of getting female athletics taken seriously. I mean there was a time when women weren't allowed to run a marathon because our uterus would fall out, which makes a lot of sense as a women's health specialist. It's gross when it happens. But each of us just does her part to make it a little bit more fair.

Nikki Kimball:                00:36:30           The unfortunate thing is each of us doing our part makes us less sponsorable. Cause if I'm out there whining about the sponsors treating me poorly versus my male counterparts, they're not going to want to sponsor me. But at this point, it doesn't matter  I'm past my professional career anyway. But I do know I probably could have been more quiet and you know, tried to look cute and race that way and because you need and probably that would have been better for sponsorship. Cause you definitely notice that the women getting on covers of magazines, it's not necessarily the fastest ones, but they're always cute. And that's not so much the case in the mens. I mean, I'm sure men face it in some ways, but I don't think that sponsorship has as much to do with how they look. And if they're willing to put pictures of themselves in a sports bra as their profile picture on Facebook or whatever. It's just a huge, huge topic.

Shannon Sepulveda:      00:37:19           It is. I know it brings me back to, I played tennis when I was younger and so it brings me back to a New York Times article awhile ago on Serena Williams and Sharapova and it was just like, how much more money she got.  She's pretty. 

Nikki Kimball:                                        That sort of Sharapova thing happens everywhere.

Shannon Sepulveda:                              So let's talk about physiology. When are the women going to beat the men?

Nikki Kimball:                                        Women beat the men when the race is long and difficult and has really bad conditions.

Nikki Kimball:                00:38:24           Men do have a physiological advantage. Yeah. They absolutely do.  That's why we need a men's race and a women's race because they absolutely have a huge physiological advantage. However, when stuff gets bad, women thrive. It was so cool to see. I know that if I'm in the last 10 miles of a hundred mile race and I come upon a guy, I'm going to beat him. If I come upon a woman, it’s on and that's not just because we're competing against each other because I see this in my practice as well. Due to biological differences we do tolerate pain better. Is that biologically something that happens so that we can survive childbirth, you know, I don't know, I think it is a real thing.

Nikki Kimball:                00:39:17           Like I think that pain probably hurts more for a guy then for a woman on average. And that's totally on average, but women just push themselves, so they're just able to push through so much. All the times I've been in a national or world class event that I've been on the men's podium, which has been three times it's been bad conditions. One of the hottest years at Western states, I was third out of the men and you know, there were a lot of men there who could have beaten me, but they, you know, it's super hot and they're just dropping like flies and the women are just kind of like were fine. So there's gotta be, you know, something going on there and how much of it is so is social construction and how much of it is biology and how much of it is psychology and you know, all of these things playing a role.

Nikki Kimball:                00:40:13           I do know that we do relatively better to the men when things get tough.

Shannon Sepulveda:                              It's like grit. I wonder if, I'm just thinking about, since I'm a women's health PT, like sleep deprivation, I wonder if women deal with that better than men do just because of we have to, we have newborns. Same thing with pain, like you have to deal with it in childbirth.

Nikki Kimball:                                        And whether we have kids or not, right? We still have those genetics to say, how would humans continue to continue? Evolve, how would any of that happen if we went, couldn't go nights without sleep and a very, very painful pregnancies and deliveries. And then come back from the aftermath of delivering a baby, which is just like, it's just something that doesn't happen in any other part of our lives.

Nikki Kimball:                00:41:11           We just don’t go rip tissue, men don't experience that. I haven't experienced that and I'm not sad to miss that. We have to be able to do that and it would make sense evolutionarily that we have some, you know, women have some capability to withstand and thrive through pain that men may not have as much access to and we also have to forget about it and do it again.

Shannon Sepulveda:                              Right. That's the other thing. And I often wonder that I'm like, Gosh, we just forget about that so quickly. Like with childbirth. It's like in a couple days or a week, you know, you forget about the pain. And I often wonder that with like, you know racing. you just forget about it. You're like, oh, I forgot how much that hurt.

Nikki Kimball:                                        And you remember that at mile something in the race and you're like, while you're racing, you're like, why did I sign up for this again?

Nikki Kimball:                00:42:12           And that's regardless of sex because we all feel it. And we all come back and do it again. There's something greater about running and racing than there is about pain.

Shannon Sepulveda:                              Do you feel like physiologically in the last 20 years, like women have made incremental gains as far as like ultra running? Are you feel like it's always been like the popular.

Nikki Kimball:                                        No, I don't think physiologically we really have changed. But I think that, and this, it goes across from men and women, is that there's just more people doing the sport. So we are with greater numbers. We're going to have more fast people and those more fast people are going to teach other, the ones who come behind them.

Nikki Kimball:                00:43:16           And like records always fall, right? Like why did nobody run a four minute mile until Roger Bannister did? And then everyone starts running, well, not everyone, but many, many elite men were running for a minute sub four minute miles. It wasn't that he was physiologically different. He was just the one to be able to say, no, that's not a barrier. You know, and I think that every time one of us breaks a record, it gives the person behind us that confidence that if the course record used to be 20 hours in and now it's 19, well now we know we can break 20 hours. And then so everybody comes to I think there's such a huge mental component to this because we certainly don't evolve that quickly. And granted, there's so much more media attention and money.

Nikki Kimball:                00:44:06           I mean, like people are now guys are making a livable wage. So few of them, you know, from running, maybe a couple, maybe some women are, I don't, I don't know. I don't think so. But we're starting to see, you know, we're starting to get a lot of gain. And also, you know, my generation of ultra runners, the women were all, we all had to work full time who aren't getting paid or we weren't getting paid well. And so, you know, I think of course records going down and people getting faster, and that's just a natural evolution that happens in every sport. I mean, the science behind it gets better, the training gets better, the food gets better, I remember one year, this guy writing, oh, my time at western states would have won in 1970 whatever.

Nikki Kimball:                00:44:55           And I'm like, let's talk apples to apples in 1970 you would have been in a canvas shoe and you might've had a potato chip and a couple bottles of water. I find that very frustrating. I do think that each generation, it's still going to be the same qualities that bring those top people up. We do bill, like I wouldn't have run the times I did had people not done similar things before me. I wouldn't have even known that that was something to go for. And so each of us who publicizes the sport and who does good things in the sport makes it easier for the person coming up behind him or her.

Shannon Sepulveda:                              How long does it take for an ultra runner to peak? Like how many years?

Nikki Kimball:                00:45:45           That's a really good question. Honestly the science isn't there. We are evidence based practice for us physical therapists is so, so important. How do like do evidence based practice on somebody who's an ultra runner? I tried to extrapolate from studies done on a marathon or maybe, but they're not even that many studies on those folks. So you know, I really don't know that we know that, but I do know a couple things. One is that people tend to have a race career of somewhere between like three and 10 years where they're really, really good, but they don't seem to have much longer than that. Like, there's a steep drop off in speed at some point. And is that mental, is that physical?

Nikki Kimball:                00:46:38           I’m not sure how linked it is to actual chronological age. You know, you might fly in your twenties and then by 31 you're kind of done, or your best 10 years might be 40 to 50. Like it just, it seems that there's some equation out there between age, miles on your body and you know, hard races run and length of duration of your running career that would sort of point to, you know, when you might be best. But I've seen, you know, I peaked at 36, I've seen people peak in their forties, people peak young, you know, so it's all these n of one groups. I mean, it's really, I love to know more it, but it's just so multifactorial. How would we ever study it?

Shannon Sepulveda:                              And everybody has different backgrounds and high school in college.

Shannon Sepulveda:      00:47:39           Right. So this would be a great transition to talk to you about hardrock this year. For those of you who don't know, Nikki came in second. And we were all cheering her on like on, so just tell us about that, your age and how that impacted you.

Nikki Kimball:                                        Yeah, hard rock was amazing. It was easy to get into it in the nineties and now is so popular that thousands of people apply for 140 something spots. So anyway, I've tried to get into it for years and I finally got in and I knew that at my peak, I would run that course really, really well. It was really made for me. It's super, it was really high altitude. You know, you're going over many peaks over 13,000 feet.

Nikki Kimball:                00:48:39           You're not getting below 10,000 feet very often. I mean, it's just, it's just fantastic and it's exposed and it's rocky and it's gnarly. And it's just a steep and fun and 31,000, 33,000 feet of gain and a hundred miles. It's awesome. So part of me really wanted to run it when I was younger and really, really strong because I'm hours slower in a hundred mile race than I used to be. I mean hours. So for this race, you know, finally get in, I know I'm not at my best. I'd also been battling an injury from a snowshoe race that really, that finally took me out later in the year. I had actually been training for about four months because of this injury had sort of taken me out for a while and I had four months of really fantastic training going into that. So not a lot, but I still had 30 years of competition to go back on, or 40 years actually of competition to go back, fall back on.

Nikki Kimball:                00:49:41           So, you know, so I get there and I know I'm not at my best, but I also know that two of the other top women in the race are also in their forties. And you know, none of us were all way past our prime. And one person who was, who was young, who, you know, who won it, you know, she's 20 years younger than me, she better be able to beat me. So it was just this magical race where we just start, you know, you just running along and talking to people cause that's a big part of ultra marathon culture is amazing and shifting with the influx of money and influx of people self promoting on social media. That stuff's really, really frustrating. But, hardrock the spirit of hard rock is very much in that old school, ultra running.

Nikki Kimball:                00:50:34           We all want to get into the finish. I mean, yes, we're going to compete against each other, but we're also really supportive of each other. And we are having a few people in the sport who aren't supportive of their competitors and that's really, really sad. But at hardrock I ended up, you know, in this group of people, one who was a PT, a pre PT student of mine. He and I along with Darla, ask you the Darla ask you and somebody had a couple of other people ended up in this group and the six person group and Jeff was my student. He and I were having a competition to see who could tell the most bad jokes. And so that was really fun. And this is the first like 20 miles. We're just kind of like chill and having fun and you do things like talk and tell horrible jokes because it makes the time go cause you can't race for all 30 hours, you're going to race for the last couple.

Nikki Kimball:                00:51:28           Sort of having that community around me just made me happy. I was running well, you know, running up towards the front and I had a bit of an explosion. Like, I just, you know, you have really bad patches and I had this massive just meltdown after one aid station and I just kind of walking up through the woods and frustrated and I know, and all I'm thinking is even five years ago, I would be, I'd be four miles ahead of where I am right now. And it was really hard and I've been dealing with the slow down for at least eight years at this point. And I just laid down in the middle, you know, like mile 29 I just laid down in the woods where nobody could see me and just sort of thought about age and really had this sort of amazing epiphany of like, I was just, I mean, I laid there for like 15 minutes.

Nikki Kimball:                00:52:34           But just thinking about, you know, why, why am I expecting myself to still be on the podium for the men and all these races when these men are now 20 years younger than me? And, you know, this is like, like I am asking my body to be what it was when I was 30, and when I was in my mid thirties and I’m 47. Like it was amazing to finally, after fighting and fighting and just being like, why am I slowing down? This is so frustrating. I'm training just as hard and I'm getting slower and now that the sports popular and people are winning with times that were easy for me at one point in my life. And, you know, just that sort of Sour Grapes of, uh, and it finally sort of occurred to me that, you know, in this little part of the race, and this is what ultra running does, is it pushes you so far that you have to think beyond the way you would think in normal situations.

Nikki Kimball:                00:53:30           And it finally sort of dawned on me, and this should have come more easily than this, but that I should be celebrating what my body can do instead of what it can't. I mean, I'm 47 and still running, you know, a hundred mile race with 30,000 feet of gain and being on the podium. Like that's huge. And I'm doing it with people I've run with my whole life and with people who, with a former student of mine who is now just graduated PT school and he actually ended up second for the men. So we ended up sharing the podium spot and you know, he's 20 years younger than me. And it just made me think about what's important in ultra running. And really what drew me to it is that I love running in the woods and that I love the mental clarity that comes with running.

Nikki Kimball:                00:54:28           And I love the community of people who do this sport. And you know, like you sort of getting back to that despite a massive slow down in my racing was critical. And it's something that I've just been fighting. I've been fighting a cancer, my body changing rather than sort of managing it. Like we talk about managing chronic pain, managing depression, managing these things. We had to manage our aging and instead of just, you know, I was totally know my body doesn't obey the laws of physiology. I'm not aging, Duh, Duh, Duh and, but you know what I am. And I had to give myself a little permission to do that. So hard rock really, really gave me that back. I mean, yes, I was probably five hour slower than I would have run it when I was 35 but I should be 47 and I have 90,000 miles on my body.

Nikki Kimball:                00:55:28           Like I shouldn't be fast anymore.

Shannon Sepulveda:                              And you still came in second which suggests you got faster, like literally like this epiphany and then you're like, I can just do this.

Nikki Kimball:                                        Yeah, kind of cause I had, you know, been caught by a bunch of people and then I just sort of gave up the results. This is hard rock. Like this is the race. People sell their soul to get into like, I'm here in the most beautiful mountains of San Juan mountains are stunning. I am having this catered hundred mile trek through this beautiful country with amazing people. That's what it is, you know? Yeah. Winning races is cool and that's fun and it's great, you know, like it's a huge ego boost and all that but it’s pretty shallow.

Nikki Kimball:                00:56:22           It is fleeting. Like you might win now, it doesn't mean you're going to win the next time. I mean, you know, there has to be something much, much bigger than results to get you to do the sport. And I think giving up any care of where I finished and just being like, you will finish this, you know, it's a gift to be able to get into this race unless you're injured, you better finish. It was just a good sort of cap to my running career.

Shannon Sepulveda:                              Yeah. It almost seems like that's almost a gift of aging because maybe you couldn't think like that when you were 35 and you did have another race. You know, like, I could never, I always did have the next thing and now you're like, I can just do this for fun.

Nikki Kimball:                00:57:13           Right. And I can coach other people and coach them in a way where I attempt to use my physiology but my physical therapy knowledge and help them to run without injury or to get any injury that comes up. We treat it immediately, we immediately manage it. We don’t run somebody into the ground and there's so many people coaching. There's no oversight in coaching, you know, who maybe took a three day course and have a certification. That does not make them a knowledgeable coach. And we're seeing that all the time. And so I like sort of, I love that I get to coach and I usually I keep about eight clients at a time because I don't want more than that because then I can't take care of them.

Nikki Kimball:                00:58:11           I can't help them. And I want people to love running and I want it to be, I want it to be healthy. In a lot of the people I work with used running as part of their mental health treatment plan. And if you're treating depression with running and you have an injury, it's disastrous. You could die. Keeping people running healthy is my new thing, you know, like that's my, you know, it's like, okay. Yeah, it was great to, you know, be the best ultra runner in the trails runner in the world for a while. That was awesome. That was really fun. It was great. Now it's more about like, what running's really about and what am always has been about. But I probably lost sight of when, you know, traveling the world and you know winning stuff.

Shannon Sepulveda:                              So let's talk about your coaching because it would be pretty cool to be coached by a world champion, technically one of the best in the world. So tell us about your coaching and what you do.

Nikki Kimball:                00:59:23           And so if my clients, I coach people locally, I mean, you know, I sort of just starting, I've taken people under my wing my entire running career and sort of coached without coaching, you know, and now if I coach people locally, it's amazing because I actually get my hands on them, you know, I can do a screen of where are they tight, where are they strong, where are they weak, where they loose, where, you know, is there something funky going on with their running? Has somebody tried to change their running gait? Because that usually messes stuff up because you have all these people who, you know, went to a CI running course and think they know my biomechanics and usually massive changes to people's gait gets them injured.

Nikki Kimball:                01:00:11           I just like being the person who runners can come to for physical therapy and for coaching who could hopefully do a better job of predicting and avoiding injury. I've treated runners for 20 years as a physical therapist. I mean because our evidence isn't great, we have to combine mechanical knowledge with physical therapy evidence on sports that might be similar and on our experience, I mean I can't, I just look back to the 1990s. I'm like, how the heck did anyone I treat get better. You know, like it was luck. Cause you know, I think of all the mistakes I made in my first, and I'm still making mistakes, but the horrible mistake I would make, things I would miss and my first 10 years of treating runners, I mean just, I mean I think that's what I can offer.

Nikki Kimball:                01:01:10           And coaching is something that's just well beyond what, you know, your person who never studied physiology or mechanics or something and there are some people who are self taught coaches who are very, very good, but they have a lot to catch up on.

Shannon Sepulveda:                              And do you coach remotely to your work with like physical therapy remotely? Like you do the screen, tell me what you found. I'll do the coaching.

Nikki Kimball:                                        Absolutely. Absolutely. And I think that's critical. The hard thing is knowing who the physical therapist is in that area. I have a Bozeman client right now whose wife is on sabbatical from the MSU. So He's traveling around. So when he's in another place, like who do I send them to for PT? And I don't insist, I mean I need hands on the people who I coach if I can, like I want to know how they're doing, but I'd certainly don't insist that they use me as a physical therapist that's referral for profit and I don't, I'm not okay with that. And there are fantastic running PTs in town.

Nikki Kimball:                01:02:19           I've got great people to send my people to and sometimes they come to me often they do and that's great too. But if I'm missing something, I want to call in another therapist because why not, why not use that knowledge that's there? So really what I found is the best thing I can, the best thing I've come up with, with getting, working with a PT, if I don't know the area, is having the athlete go to the running store, they're running specialty store and say who's good here. Not to say that it's always going to give you the best result, but, you want to go to a therapist who has seen runners, who's worked with runners, because it's just a different skill. I mean, you're not going to come to me for neck pain because like, no, I give you really a problem.

Nikki Kimball:                01:03:06           So I think that can help. And then physical therapists who specialized with treating runners were super geeky about it and we love when our patient comes and says, Hey, can you talk to my coach? She's also a PT or ex phys. I mean oftentimes or physiologists. I mean, you know, like what I, you know my strength and in biomechanics I also have a weakness of physiology cause we don't study it as much. So it's great to be able to talk, you know, if one of my patients says, Hey, I want you to talk to my coach. And they sign their release. It's fun to talk to their coach and be like, Hey, and you just, you know, the coach is going to see if it's something different than the PT is and you know, and you really work together. I love that part of it.

Shannon Sepulveda:      01:03:51           Oh yeah. I mean even with me and when I have, you know, women who come to me that leak when they run and I'm like, I'm really good at making you not leak when you run, maybe making you not have prolapse symptoms when you run. I'm not your performance coach. Like you go see experts and experts and an expert and they're going to like Dork out on the stride and you know the form and everything. Right. But I can help your pelvic floor when you're running. Exactly. And that's why we specialize. I was like, you know, you can geek out with running.

Nikki Kimball:                01:04:33           Like I could go to so many courses and I don't have time to do that. It's not my forte, but these people are really good at it. And the thing is you're really good at women's health, pelvic floor stuff because it's what you do. And you applied the geekiness of pelvic floor health that I applied to running. So of course, yeah, of course. I want my person with incontinence to see you and my person who was a runner to see me and I think if we all shared it would be great.

Shannon Sepulveda:                              It would be so great because as you realize how much more you don't know, even when I have an injury, I go see a PT, like I'm not treating myself. I don't do stuff right. I never do it. So I think your PT tells me, he tells me to do it, I do it. And they do hands on things that are just so different. And so I go see a PTs all the time for my stuff because I'm really good at what I do and they're really good at their niche and what they do. And PT is such a huge field that you can't be good at everything. Well, so where can people find you if they want coaching?

Nikki Kimball:                01:05:20           I've always done it word of mouth, but it's is sort of my public address that people can reach me at. Facebook doesn't really work because I get frustrated, but don't answer stuff. I just love coaching people of all levels, you know, but again, you know, I'm going to coach somebody for mostly ultra running or I love coaching, people in their fifties, sixties, seventies for shorter distance stuff because I think masters in veteran athletes, you know, athletes over 50 have, you know, they have so much to gain from sport and the book knowledge I have, there is no way I could have coached people people past, you know, 45 and before I realized a massive slow down myself.

Nikki Kimball:                01:06:46           It doesn't matter that you get it intellectually. You don't get it until you feel it. And when I'm three minutes a mile slower than I was at my best, you know, you know, you know, age is something.

Shannon Sepulveda:                              It is, it totally is. I mean, it's the same thing when, you know, I have pregnant women that I've never had a baby before and then want to run a, you know, I thought I could run a 5K like eight weeks after I had a baby before. Because when you don't know, I know it happens to you and then you're like, oh yeah, like I do get sore with age. Childbirth does something to your body, right. You don't know until you experience it and you can't expect someone to know that you can't.

Nikki Kimball:                01:07:39           The other thing, I mean, it's not like all parents throughout history haven't told their kids. You just wait. Sony. I mean, but it doesn't matter. We can say those things. It doesn't, it doesn't, you don't get it until you go through it. I mean, and I think book knowledge is super, super important and evidence and all that, but experience can't be discounted.

Shannon Sepulveda:                              Well, and it's also really nice to have someone that has gone through it and knows because you want someone that has been through it and knows what to do and has experienced that. So they can have empathy for you as a person, as an athlete, and assist you.

Nikki Kimball:                01:08:16           And also, you know, if it took me nine years to come to terms with my aging as an athlete, well, why would I expect my 57 year old runner to be okay with running a 30 minute 5K when she used to run a 20 minute 5K? Like how? Yeah. You know, like, it's important, you know, to have gone through that too, you know, I don't know, you know, seeing as it took me forever to teach myself that lesson and I still don't think I'm completely there. I don't know how well I do helping people through that. But I wish I had had some buddy who had gone through that slow down with me when I did.

Shannon Sepulveda:      01:09:12           Thank you so much for coming on the podcast. We'd really, really appreciate that.



Thanks for listening and subscribing to the podcast! Make sure to connect with me on twitter, instagram  and facebook to stay updated on all of the latest!  Show your support for the show by leaving a rating and review on iTunes!


Mar 26, 2019

LIVE from the Align Conference in Denver, Colorado, I welcome Kory Zimney and Jessie Podolak on the show to discuss why language matters to patient care.  Dr. Zimney is an Assistant Professor within the Department of Physical Therapy at the University of South Dakota, Senior Faculty with International Spine and Pain Institute (ISPI), and researcher with Therapeutic Neuroscience Research Group and USD Center for Brain and Behavior Research. Jessie currently owns and operates her community's first direct-pay physical therapy practice, seeing a variety of patients with acute and chronic pain conditions. She has been teaching pain science and manual therapy techniques at continuing education courses since 2013.

In this episode, we discuss:

-How language affects your actions

-Looking at language through the patient perspective

-What is negative effective priming

-Ways that you can enhance your communication style

-And so much more!



Align Conference

Kory Zimney Twitter

How to make stress your friend Ted talk


For more information on Kory:

Kory Zimney, PT, DPT has been practicing physical therapy since 1994 following his graduation from the University of North Dakota with his Masters in Physical Therapy.  He completed his transitional DPT graduate from the Post Professional Doctorate of Physical Therapy Program at Des Moines University, Class of 2010. At this time, he is in the candidacy phase in the PhD PT program at Nova Southeastern University.


Currently Dr. Zimney is an Assistant Professor within the Department of Physical Therapy at the University of South Dakota, Senior Faculty with International Spine and Pain Institute (ISPI), and researcher with Therapeutic Neuroscience Research Group and USD Center for Brain and Behavior Research. His primary teaching, research, and treatment focus is with pain neuroscience, therapeutic alliance, and evidence-based practice for orthopedic injuries of spine and extremities.  He has published multiple peer reviewed research articles in these areas. Past work experiences have been with various community-based hospitals working in multiple patient care areas of inpatient, skilled rehab, home health, acute rehab, work conditioning/hardening and outpatient. 


He has completed the Advanced Credentialed Clinical Instructor program through the American Physical Therapy Association and is a Certified Spinal Manual Therapist (CSMT) and assisted in the development of the Therapeutic Pain Specialist (TPS) through the ISPI certification program; and has a Certification in Applied Functional Science (CAFS) through the Gray Institute.


For more information on Jessie:

Jessie received her Master's Degree in Physical Therapy from the College of St. Catherine, Minneapolis, in 1998. She completed her transitional DPT from Regis University, Denver, in 2011. She has been teaching pain science and manual therapy techniques at continuing education courses since 2013. Jessie currently owns and operates her community's first direct-pay physical therapy practice, seeing a variety of patients with acute and chronic pain conditions. She has special interests in manual therapy, Pilates, spine and running injuries. She is a certified clinical instructor through the APTA and has completed her Therapeutic Pain Specialist certification through ISPI.





Read the full transcript below:

Karen Litzy:                   00:00                Hey everybody, welcome back to the podcast. I'm your host, Karen Litzy coming to you live from the align conference in Denver, Colorado. And I am fortunate enough to be sitting here with Kory Zimney and Jessie Podolak and we're going to talk about the workshop that they did yesterday and will probably do again tomorrow on moving our language and why language matters around people with persistent pain. So my first question is why does it matter?

Jessie Podolak:                                      Well, words are powerful. We started off by just doing some cool quotes that words change worlds, right? And words can pierce like a sword.  The tongue of the wise brings healing. And that's just ancient wisdom, right? We've known that words just have so much power. They shape our perceptions, they shape our action.  We know even from the research, just how we look at something.  So for example, one of the studies we cited was if crime is presented as a beast, okay, crime is a beast versus crime as a virus.

Jessie Podolak:              01:12                When crime is presented that way with just those two words. And we survey people and we say, what should we do about crime? Those who hear crime is a beast, 71% say we should increase law enforcement. 51% of those who hear crime has a virus say we should increase law enforcement. So the word evokes more of an action response when we hear the beast versus virus. And other one was the economy, is the economy stalled or is it ailing? If the economy is stalled, we jump start it, right, stimulus package. If it's ailing, maybe we take measures that are really going to do long term change. We look at education levels or socioeconomic things and what can we do with this economy? So words shape so many things in general and in healthcare, the word surrounding pain, can evoke a lot of fear.

Jessie Podolak:              02:08                They can evoke a lot of a knee jerk reactions of what needs to get done. It can kind of force us to look at these more short term solutions. And I think that's been a theme emerging throughout this conference is that there's so many things that we do that are helpful in the short term but can actually be harmful in the long term. So the words that we have surrounding pain, probably lend themselves many times to short term solutions. And if we want to look at really a sea change in how we approach pain, we've got to think and consider our language.

Kory Zimney:                02:45                When we look at what we're just talking about, you know, a lot of people, I think they look at it and they go, well that's just a little change. You know, it was only 20% different. What's the big deal? And to me, you know, and it's all about nudges, that a lot of times it's just these little changes that can make huge difference for some people. And I get for a lot of people it probably wouldn't make a big difference, but if it did make a difference for a person, why wouldn't I want to try to maximize every little opportunity that I could get? And I know some people look at it like, well, I don't think language is that be all, a lot of people I can tell arthritis and they don't have a problem because I used that word and I get that. But what about that one person that it did make a difference for? How do you know it didn't make a difference for somebody? And if we have good evidence that shows that these little changes can make a difference, why wouldn't we try to maximize every little bit of that?

Karen Litzy:                   03:33                Yeah. And I think that harks back to Kory to what you said this morning about everyone in the room has probably treated one person in pain and that's great. You treated one person, but you can't extrapolate what works for one person to a population. And so I agree that I think in as much as saying, do no harm, changing words around that might connect with someone I don't think is going to be incredibly harmful. By reframing words that maybe we know might be a little harmful. Like arthritis or what are some other ones from yesterday?

Jessie Podolak:                                      One for me was wear and tear. How often do we say wear and tear. And what's the first thing that pops into your mind when you hear wear and tear? What's an object? Yeah, the tire. And what's that gonna do? It's gonna blow.

Jessie Podolak:              04:24                Right? So if I say you have wear and tear, what is kind of even a subconscious thing? They're just waiting for it to blow. And how does that influence your movement? How does that influence the adventure you have in life? How does that influence your whole being? Just knowing I have wear and tear for some people they might say, well I don't care. I'm going to wear it out. I'm going to grind that thing to the ground. But for others they might say, oh my gosh, these tires have to last me another 20 years. I better take really, really good care and back way off. So wear and tear is a hot button one for me.

Kory Zimney:                05:03                But yeah, so it's just those little phrases that are so easy for us to throw around. But we have to recognize that the lens that the patient looks through is probably different than the lens that me as the therapist with all my education and training on how I look through it. And I think that's just, again, taking that patient perspective is something that we all can hopefully try to do a little better sometimes.

Karen Litzy:                   05:28                Yeah. And one thing from yesterday's class that I had never heard of before was negative effective priming. So can you explain what that is and then how we use it maybe not even knowing we're using it as therapists.

Kory Zimney:                05:43                Yeah. It’s really kind of what you talk about is kind of what you start thinking about. And so if I'm telling you how you're going to lose, if you don't do your exercises, you won't be able to do these things. And just create more of a negative type of attitude to everything, in everything the patient sees then will be directed more towards the negative.  Where if you can flip it to more of a positive type outlook as far as when you do this, you'll be able to do these things and you can do that. And again, always flipping it to more of a positive direction. So again your just priming them, nudging them, turning them towards things that they can do as compared to, you lost this, you won't be able to do that. So, it's those little shifts and changes to focus on those positives. As a clinician, you know, you struggle like our patient’s so negative. And then we come up with these negative phrases sometimes and it's like, well, how are we helping prime them the right direction?

Karen Litzy:                   06:34                Right, and what are some examples of maybe common negative priming that we may do as therapists?

Kory Zimney:                06:41                If you don't do your exercises, you know, that shoulder's gonna only get worse. You know, if you're overweight, you know, this puts lots of extra pressure on your knees, they're more likely to wear out. It’s just those little negative type of things. It's so easy. We can look at, we were talking about what they lose, you know, the kind of the gain aspect or the loss aspect. And oftentimes we tend to talk about the losses and patients will get focused on that, on the negatives. That's just human nature that we focus on negatives.  As a clinician, if we're adding to that, it's only going to multiply more. Back in younger days as a clinician, I'd always get so proud of, you know, if I could get their problem list to 10, I thought, how cool am I am double digits.

Kory Zimney:                07:24                You know what I mean? Just get that problem list as long as possible, you know, but really looking at the optimism list, what things can they do? You know, what things can they do better? And you know, isn't that, how cool is that? That you can do that? In focusing on those things and what they can do better, what things they can do instead of on what things they've lost, what things they couldn't. So that's that kind of priming a kind of nudging more into a positive direction compared to our traditional, you got dysfunction, you can't do this, you're broken.

Jessie Podolak:              07:50                Yeah. And even the way we asked that question, Lindsay had just a really nice thing this morning that she talked about with goals instead of, you always think of, you know, what are your goals? And that's kind of an obscure thing, but I think she asked it in a way that was something like, tell me something that you'd like to do more of, be better at, or return to doing that you currently can't. It flipped it because it started, you know, there's this great quote from a Ted talk that I love by Kelly McGonigal called making stress your friend. It's awesome. She has this quote in there near the end where she said, you know, it's so easier to run towards something than away from something. And if you look at your patients, what are they right in their goals?

Jessie Podolak:              08:29                I want to get rid of this pain. I want this away from me. I want to avoid it. It's so overtaking their life that they're running from it. But if we can just direct people towards what is to come and even get them to maybe cast a little vision, which I know is scary. Right? And you don't want to have false hope. We talked a lot about that, about how to balance reality and honesty. And sometimes to say, I'm not sure how this is going to turn out, but I'm with you in it. Right? But I think, you know, this is the worst I've ever seen, or man, this is the biggest trigger point I've ever felt, no wonder you hurt.  Those things come from a place of pity or sympathy which it's well intended, but it's not as far on the empathy and compassion scale that we want.

Jessie Podolak:              09:26                We want that empathy and compassion of, I see where you're at and where you've been, but I'm with you as we go forward, I guess how I look at it.

Karen Litzy:                                           Absolutely. And I think that sentiment of yes, I'm with you, but being honest, so doesn't mean everything's pie in the sky. And I think that's where people, when they hear about this, explain pain, quote unquote or PNE, they think, oh, you're just talking away the pain and you're not being honest. You're not being realistic. But that's not what we're saying when you're talking about language and talking about communicating with someone who has persistent pain. So one of the examples we used yesterday was like hippo A and we said, you know, yes, you're, you may have pain and we're going to work on strengthening.  There is a chance you might need surgery, but if you do, you'll be stronger going in. So you have to be honest, you can't say to someone with severe hip OA, you'll be fine. Just do a couple exercises. It's just not realistic. And then when the person isn't fine, that's a steep fall.

Jessie Podolak:              10:18                Yes. And it goes back to this, not swinging too far on the pendulum away from the bio, it's still bio-psychosocial. And how do you explain something that there are biomechanical issues in a way that's not scary that still honors the bio, but that kind of de-catastrophizes or softens, it's really just about softening and responding. Like watching the patient's nonverbals. You can tell when you're starting to freak somebody out. And so then you make the adjustment and you just be very, very present.

Jessie Podolak:              11:12                So it's certainly our language, but like, as you know, Kory talked about is communication. And I really like what Jonie said about pain neuroscience communication versus just education, I the smart therapist I'm going to teach you, silly patient about how this works. No, this is about communication and dialogue and how do we do that?

Karen Litzy:                                           Yeah. And Kory, I think you said this yesterday, but correct me if I'm wrong, I think you said that the body is not fixed rather a robust ecosystem that has the ability to change and grow.

Kory Zimney:                11:54                Yeah. And that was actually a TPS grad that we have that talked about that. The beauty of the amazing plasticity and I mean I go back to when I used to, you know, work somewhere in our rehab unit and when a patient came in with a stroke, you knew there was brain damage and you could see the MRI report. But the beauty is you had no idea what they might be able to function and do afterwards, right? Because you'd look at those areas that were destroyed, where the infarct was and stuff like that. And some of them amazingly regained function and the ability to walk and their ability to transfer and get out of bed. So you just always had this ultimate optimism, you know, as the traditional neuro type of Rehab Therapist, when somebody would come in with their stroke or spinal cord and in their ability to be able to do things. But for some reason in the orthopedic world, we just have this like, oh, well, yeah, sorry.

Karen Litzy:                   12:38                Yeah, sucks to be you.

Kory Zimney:                12:44                We just create this, like the body can't be adaptable to these things. And now that they've done the imaging studies on normal people, we're all walking around this stuff. We've all had this beautiful adaptability, whether it was from a neurological orthopedic, any kind of change that's gone on on our body, but we don't ever appreciate, and look at that from that optimistic again in realistic sense, you know. But again, we know that if you have a little tear in your meniscus that might be an issue. Yes, it's a huge bucket handle and you can't straighten your knee out and it clicks every step. Yup. That's probably a major deal. But otherwise a lot of people can get by with that. No, I don't know with absolute certainty, but the beauty is we should be able to find out in four to six weeks because we can train the body, help it become more adaptable. We can explore different motions and movements and see how you do with it. And if it still doesn't, the awesome thing is we do have surgical options, to make that better. And so that's just that beauty of appreciating the adaptability of the human body. And I don't know that we, for some reason, we seem to have lost that appreciation to some degree.

Karen Litzy:                   13:46                Yeah, and I think that's something that I know I'll be using with my patients just to say, listen, you are this robust ecosystem, and I think if we share that with all of our patients, I think they may have a mind shift change there.

Jessie Podolak:                                      Yeah. If you think of ecosystems, so many things go into it. Yeah. Right. It's not just the musculoskeletal. I think just that if people could really view the body as juicy and more robust and just multifactorial, and I think that's where maybe we got off track is we just started seeing the body as a machine.

Karen Litzy:                                           Which I have to say is my pet peeve. I hate when people say, your body's just like a car. I'm like, no, it's not because the car doesn't breathe. We're not mechanics. We're not this. Like that is not how it works. Where I'd like to think as people we’re a little more complex and in a very good way, right? So now what would be the thing that you want people to take away from why language is important when it comes to working with people with persistent pain.

Kory Zimney:                14:56                For me it's just being mindful of that, you know, taking that moment and again not to as a therapist, don't overthink it either. Don't think, oh, what words can I say? And if I said arthritis all crap, their patients going to catastrophize and never be able to walk again. No. But just be mindful of it and be present with your patient. Because when you're truly present with your patient, you can see that look in their eye and you can get that sense that they may be getting a little bit worried or catastrophizing or a little anxious and stuff like that. So it's that ability to just be present and mindful that words do matter. But again, not so overly mindful that you freeze and you don't act either. We still have to just be human, just being a part of that. And again, that's just that communication piece that really is what we're talking about.

Jessie Podolak:              15:38                I would just echo what Kory said. It's just be with your patients. Care, invest in them. Some of the patients who it takes every ounce of energy they have just to make it to your appointment. Realize that they're giving you the trust and kind of the gift of their time and their precious energy. And so, even when you have that busy day, even when you know you're kind of sucked dry, just to give them that time that you have with them and to slow down a little bit, listen, be mindful and you know, I just think it's just about being a little softer, just softening out the rough edges and being that safe place. You know, Louis Gifford, one of our heroes said reassurance is an analgesic and sometimes we can't reassure that that hip is going to not need surgery, but we can reassure that I'll be with you. We’re in this, I'm in this with you. So that's what I would say.

Karen Litzy:                                           Awesome. Well, thank you so much, Korey, Jessie, I appreciate both of you and I really enjoyed your talk yesterday, so thanks so much for coming on.


Thanks for listening and subscribing to the podcast! Make sure to connect with me on twitter, instagram  and facebook to stay updated on all of the latest!  Show your support for the show by leaving a rating and review on iTunes!


Mar 21, 2019

On this episode of the Healthy Wealthy and Smart Podcast, Jenna Kantor guest hosts and interviews Duane Scotti on social media marketing.  Dr. Duane Scotti is a physical therapist, educator, researcher and founder of Spark Physical Therapy. He is considered a leader in the fields of rehab, sports medicine, performing arts medicine, and human performance optimization. With years of experience as a physical therapist, runner, and dance instructor in combination with his strength and conditioning background, Duane has been working with many patients to improve all aspects of human performance.

In this episode, we discuss:

-How to decide which social media platform is right for your marketing strategy

-What social media content will best build loyal customers

-The benefits of scheduling out social media content in advance

-And so much more!



Duane Scotti Twitter

Duane Scotti Instagram

Spark Physical Therapy Facebook

Spark Physical Therapy Website 

The Clinical Outcomes Summit 

For more information on Duane:

Dr. Duane Scotti is a physical therapist, educator, researcher and founder of Spark Physical Therapy. He is considered a leader in the fields of rehab, sports medicine, performing arts medicine, and human performance optimization. With years of experience as a physical therapist, runner, and dance instructor in combination with his strength and conditioning background, Duane has been working with many patients to improve all aspects of human performance.


Duane is currently the founder of Spark Physical Therapy, providing prehab, rehab, and performance optimization services either onsite or in the comfort of your home within the Cheshire/Wallingford CT region. He also is a clinical assistant professor in the Department of Physical Therapy at Quinnipiac University responsible for coordinating and teaching musculoskeletal examination, intervention, and advanced manual therapy within the orthopedic curriculum.


Duane received his Bachelor of Health Science degree and Master of Physical Therapy degree from Quinnipiac University in 2001 and 2003. He then went on to receive a clinical Doctor of Physical Therapy and a Ph.D. in Physical Therapy from Nova Southeastern University in 2017. Duane is a board-certified Orthopaedic Clinical Specialist, Certified Mulligan Practitioner, certified in dry needling and has advanced training in spinal manipulation, dance medicine, gymnastics medicine, and rehabilitation for runners.


Duane has been in clinical practice working with orthopedic, sports, and performing arts populations since 2003. He has strong clinical and research agendas in screening, injury prevention, and rehabilitation for runners, dancers, and gymnasts. Duane uses an integrative model of manual therapy including manipulation, mobilization, and soft tissue treatment including dry needling and the Graston technique for the management of musculoskeletal dysfunction. Duane is a physical therapy advocate and is actively engaged with the American Physical Therapy Association and serves as Vice President of the Connecticut Physical Therapy Association.


For more information on Jenna:

Jenna Kantor (co-founder) is a bubbly and energetic girl who was born and raised in Petaluma, California. Growing up, she trained and performed ballet throughout the United States. After earning a BA in Dance and Drama at the University of California, Irvine, she worked professionally in musical theatre for 15+ years with tours, regional theatres, & overseas ( until she found herself ready to move onto a new chapter in her life – a career in Physical Therapy. Jenna is currently in her 3rd year at Columbia University’s Physical Therapy Program. She is also a co-founder of the podcast, “Physiotherapy Performance Perspectives,” has an evidence-based monthly youtube series titled “Injury Prevention for Dancers,” is a NY SSIG Co-Founder, NYPTA Student Conclave 2017 Development Team, works with the NYPTA Greater New York Legislative Task Force and is the NYPTA Public Policy Committee Student Liaison. Jenna aspires to be a physical therapist for amateur and professional performers to help ensure long, healthy careers. To learn more, please check out her website:


Read the full transcript below:

Jenna Kantor:                00:00                Hello, this is Janet Kantor with Duane Scotti, a physical therapist from Connecticut who is joining me today on healthy, wealthy and smart. And today we're talking about doing a specific niche on social media and really just nailing it. You are nailing it, Duane. So first of all, thank you so much for coming on.

Duane Scotti:                00:19                Thank you for having me. This is awesome. I'm very happy to be able to talk to you about this topic today.

Jenna Kantor:                00:26                Yes. So I would love to know first, how did you choose what social media platform you were going to put most energy on or also I've seen you on Instagram, but you may also be on other platforms and I would just love for you to expand on that.

Duane Scotti:                00:41                Great question. When I was looking into kind of getting into social media and using it as a platform, I thought about what is my audience, right? So most of the patients that I treat are adolescents, so I basically treat gymnast runners and dancers and a lot of them are on Instagram. So I started the Instagram account and started learning everything I could learn about Instagram, but their parents are on Facebook. So a lot of, you know, their parents are on Facebook and there's different groups on Facebook. So that's been beneficial from that standpoint. So those are really the two platforms that I utilize. I do have a Twitter but I haven't used it. Primarily because that's more for professional and other PT’s and that's not really my target audience.

Jenna Kantor:                01:27                Right, right. Absolutely. I like how you hit the nail on the head regarding Twitter specifically, I'm not as active myself. I have something set up where it automatically posts, but my heart isn't there because that's like you said, not where my target audience is. And I like how you bring that up. So how does your content differ from Facebook where the parents are, to Instagram, where the kids are?

Duane Scotti:                01:52                There's not too much differences in terms of I do post the same content basically to both platforms. The messaging is a little different if I'm sharing it to a group. So specifically at our local dance studio, we have a closed group so my messaging is going to be a little bit different, kind of targeting the parents and looking out for their dancer, as well as the stories on Instagram. So the stories are on Instagram are a little different, but the content posts that I do on a daily basis, they are going to be the same post that just instantly goes over to Facebook and I'll shoot it over there from Instagram.

Jenna Kantor:                02:27                And you just mentioned a little bit about you have kids who are going to these dance schools. There's a relationship you already have with these parents that's helping you build these groups. Would you mind elaborating a little bit more on how that came about?

Duane Scotti:                02:44                Yeah, so, well I guess first off, I do have two daughters. One is a dancer and one is a gymnast

Jenna Kantor:                02:49                Shout out to your kids.

Duane Scotti:                02:51                So they are at the local gym, the local dance studio that I've been affiliated with awhile. I also taught at the local studio, I was a dance instructor there. And you know, obviously those relationships, the families, they kind of have known me and trusted me for years and I've helped out their dancers before. So those are kind of how those relationships have been built. It's really more of me just being present and being there for, you know, picture day and you know, I'm there doing, you know, kind of complimentary screenings and things of that sort. So you kind of develop that rapport and relationship with the families where you kind of earn their trust, that you're going to be kind of looking out for their dancer.

Jenna Kantor:                03:34                You know, you hit upon something that I think is so valuable. I actually interviewed Karen Litzy the other day for her own podcast, this podcast in which we are interviewing for right now. And she was talking about these relationships and how she just lives her life and through the things that she's already passionate about. She's made these relationships and help those relationships grow. And it sounds like that's what you have hit upon, which you agree.

Duane Scotti:                04:01                Absolutely. Absolutely. Relationships are everything and from a practitioner standpoint, your relationship with your patient and their families are important. But then expanding beyond that and you know, things are a lot different than the healthcare world. And when I first graduated, you know, it was prior to direct access time and everything was about trying to foster that relationship with your referring physician. Now it's a completely different animal. You know, my relationships I'm fostering with are the communities in which I serve. So looking at the gymnastics community or it's the relationship with the coaches, right? And having, you know, I'm just thinking about the first facility that I started in, it was talks with coaches, not just one saying, Oh yeah, I'm a physical therapist, let me treat your gymnast. But it was many talks, many conversations you developed that rapport, that relationship, and then that turns into, hey, can you help this gymnast out?

Duane Scotti:                04:56                Oh we have another one. Can you help this one out? And then you kind of foster that relationship over time and then you wind up seeing, you know, your practice or your business kind of growing from that standpoint. And it's really kind of getting into our communities and for me at least that has been successful is having those relationships with, you know, the dance studio owners, the gym owners, now we're treating out of an aerial silk studio. So really you develop that relationship and then they recommend your services to people that are in their circle, right. And their business because they trust you. So I think those relationships are definitely, definitely important for kind of long term success.

Jenna Kantor:                05:38                Yeah. And it just makes it more enjoyable because you honestly enjoy each other and so I think that's great. So let's go back to the social media stuff. Your content itself, I mean, I've seen the video of you dancing with your daughter, which was great. What was it? The diggy?

Duane Scotti:                05:53                That was the Kiki challenge.

Jenna Kantor:                05:56                I think that video pretty much went viral. Am I correct?

Duane Scotti:                06:00                Yeah. That one was definitely my best performing video. So yeah, it was fun. That was something that, you know, a lot of people were doing that. And I think you saw on the news like a dentist had done it. I was like, you know what, we should do this as a physical therapist and just showcase what physical therapists do. So, you know, my daughter's a dancer and she was interested. I said, Gabby, let's do it and let's do a little dance. So we just kind of put it together real quick and that was fun. And that's the thing I do like about social media. It's really nice. You can have fun with it. We are professionals and we always have professional interactions with our patients, but we also have fun with them.

Duane Scotti:                06:37                Right. And we're human, we’re people.  So just kind of showing some of that human side I think has been definitely beneficial. And you know, if you look at your insights on, you know, Facebook or Instagram, the posts that do the best are the ones where I am not trying to be super serious and I'm not showing the best technique and the best tool in my toolbox that I know it's more of me just being genuine and it's more of you know, doing a silly dance or you know a picture with the family or you know, something that's kind of outside the box.

Jenna Kantor:                07:14                It lets people feel more connected to you. So let's go into more on Instagram because Instagram unlike Facebook, Facebook you can schedule posts for free, Instagram you can’t right? So are you using one of those paid for platforms to post or do you just post daily and what is your schedule that you abide by to be consistent?

Duane Scotti:                07:40                Well, you hit a really important point is that consistency is key with Instagram and Facebook. It is one of those things and it's just like anything we do in life habit, right? Exercise goals, running goals, wherever it is. Getting to the gym, you gotta be consistent and I don't know, people for different things what like two or three weeks to form a habit and then it becomes a habit. And for me that's been helpful where now it's just part of my daily routine and scheduling it in advance and doing batching and kind of putting videos together, putting, you know, writing, you know, batching all your posts together. It's definitely helpful. It makes it easier. But unfortunately Instagram does not have, like you said, where you can schedule out your posts, so you do need to post it. Then I have heard of other platforms that you can utilize to put your posts in, but it still will send you a reminder to your phone saying this post is ready to go. And then you'd have to open Instagram and actually post it. So that is the limitation in terms of time management. So it is “work” where you need to think about it. Hey, I have to post on this day. I've thought about and you know, and maybe in the future trying to delegate a bit of that out, just to ease a little of the burden of having to do that. And I actually trialed that shout out to Nikki when I was on vacation.

Jenna Kantor:                09:04                Hi Nikki. I don't know who you are, but thank you.

Duane Scotti:                09:07                She did an awesome job and I wrote all the posts in advance and she did the posting for me when I was out of the country and I couldn't post. So I think it's a doable model, but you still needed to write the post. And because I think, again, going back to being human and genuine, right? So a lot of these bigger businesses, you know, they have marketing people who are doing their posts, but you can tell it's more from a marketing angle and standpoint. It's not that person being genuine and who they are.

Jenna Kantor:                09:34                That was so eloquently said. I don't know if we'd go out for coffee, but good, good job.

Duane Scotti:                09:41                Right, right. So that is, you know, on Facebook they do have the scheduling, but if you're going to wind up forcing an Instagram, again, like I said, you can just shoot it over to Facebook then. So yeah, I unfortunately don't have a scheduling system that will just like send them all out. Which would be nice.

Jenna Kantor:                09:58                And then for the content preparation, do you pretty much do like on Sunday you prepare for the week or do you kind of do daily? Do you have a system for that yet or how do you do that?

Duane Scotti:                10:10                Sure. I don't do that specifically on Sundays, but on Sundays I do iron all my outfits for the week.

Jenna Kantor:                10:15                You buy clothes that you need to iron? That's lesson number one. You're supposed to buy shirts that are iron free, like you don't need an iron. So let's start there. Now move onto the creating of content.

Duane Scotti:                10:33                Yeah. So it's really whenever I have free time, so there's no specific day where I'm like, okay, Sunday is the day that I'm going to do all that. It's whenever I have a chunk of time, then I have a calendar. I have a plan for what's going to be coming out when and then it's a matter of all right, I'm going to do these videos, whether I'm going to write some captions in the videos from adding music, whatever the case may be. And then I have all those ready to go. So that's like my videos ready to post folder on my phone there. And then I will have the write ups. So then whenever I have free time it's like, okay, let's write up this post that post that post. And so then it's kind of done in advance. Ideal world is I would have like a full week's worth of content and I found that is so much better because it's not stressful thinking about because your day is busy, right?

Duane Scotti:                11:17                So I teach during the day, you know, doing the practice in the evenings and on the weekends. And you know, if I get to the point where it's, oh, I don't have a post today, it’s stressful and then you have the pressure of coming up with something right on the spot. And so having it in advance, it's a lot easier where it's ready to go, the writing is done, the post is actually done, the videos are done and then it's a matter of just literally opening up the platform and hitting the plus button and there's your video and copy paste, boom, boom, boom and then you're off and running.

Jenna Kantor:                11:48                Yeah. And you're hitting upon why I'm actually considering investing in an Instagram, a paid for platform to post for Instagram because this is where the value of being able to schedule it out really comes in because you could schedule it out for a year. I mean, imagine that you just hammer it out, you know, you're like, I love you children. You go play, you get to watch movies this whole weekend while I create content. And then you pull them in, you say, hey, you know what, I would like you to create choreography to five songs. So then you could do the family thing a couple times. But yeah, I think that is a key thing to maybe even tap on. I'm actually brainstorming for myself, not even giving you advice because for me, Instagram personally is a platform that I'm just about to start going for. I took the time with Facebook first, I'm very on top of that and now Instagram is my next target to like create those habits. So it's really good for me as a practitioner to hear what you're doing, what your experience is and how possible it is, so thank you.

Duane Scotti:                12:58                Yeah, I know. And on Instagram, you know, it is a little different from Facebook in that I feel like you need to write a little less. And attention spans are a little different on Instagram. So, you know, those things are different and obviously the hashtags are important on Instagram, whereas Facebook, they're not. So you know, knowing which, you know, tags to use can help bring your reach to a wider audience and kind of your target audience. So you do have to give some thought to the actual tags that you are going to use on Instagram, which I think helps, you know, get your stuff seen.

Jenna Kantor:                13:35                Yeah. How did you find the Hashtags for you? Because you could sit there and say Hashtag dance and see that a lot of people post dance, but if you're going to really target the people in your area, how did you get those hashtags?

Duane Scotti:                13:48                So I do some local hashtags. I'm still looking at towns, right. So Wallingford, Connecticut, Cheshire, Connecticut, North Haven, Connecticut and we'll look at those local tags. And I don't know if anyone really truly knows the answer to the algorithm. But it is, you know, do you go with the hashtags that have the most numbers or because there's so many things posted on them anyway your stuff's never going to be seen. Or do you go with some that aren't in the millions or the hundreds of thousands so you can get into your niche, right? So I try to make them relevant to whatever the post is and then relevant to my target audience and you know, looking at if it is something on the ankle and ankle pain or maybe you're someone searching for that or ankle sprain I use those tags.

Jenna Kantor:                14:38                Yeah. That's great. Well, thank you so much and my last question would be do you consider yourself an expert on social media?

Duane Scotti:                                        Definitely not.

Jenna Kantor:                                        That is where I think it's perfect to end for all you practitioners. We have worked so hard to get our licenses to work on these patients in physical therapy or honestly in any health career that you are pursuing. You don't need to be an expert. You just need to start. And the more you do, the more curious you get and the more you will learn. And Duane Scotti here is definitely a perfect example of that. So thank you so much for coming on this podcast and sharing your knowledge.

Duane Scotti:                                        Yes, thank you so much for having me.



Thanks for listening and subscribing to the podcast! Make sure to connect with me on twitter, instagram  and facebook to stay updated on all of the latest!  Show your support for the show by leaving a rating and review on iTunes!


Mar 18, 2019

LIVE from Graham Sessions in Austin, Texas, I welcome Justin Moore on the show to discuss the American Physical Therapy Association.  Dr. Justin Moore, PT, DPT, a physical therapist and veteran of both the profession and the association with more than 20 years' experience, leads the American Physical Therapy Association in the role of CEO. He has been with APTA for 18 years and has held numerous positions, including executive vice president of public affairs, leading the public policy agenda and payment and communications departments, leading its federal and state affairs advocacy departments and serving as the association's lead lobbyist on Capitol Hill.

In this episode, we discuss:

-How the APTA strives to provide an inclusive experience as a macro organization

-What Justin would change about the APTA

-APTA’s role in the World Confederation for Physical Therapy

-Justin’s biggest takeaway from the Graham Sessions

-And so much more!




Justin Moore Twitter

Justin Moore LinkedIn

World Confederation for Physical Therapy Congress 2019

The Healing of America by T.R. Reid Book


For more information on Justin:

Justin Moore, PT, DPT, a physical therapist and veteran of both the profession and the association with more than 20 years' experience, leads the American Physical Therapy Association in the role of CEO. He has been with APTA for 18 years and has held numerous positions, including executive vice president of public affairs, leading the public policy agenda and payment and communications departments, leading its federal and state affairs advocacy departments and serving as the association's lead lobbyist on Capitol Hill. Moore also previously oversaw APTA's practice and research departments. He has been honored for his contributions to physical therapy and public policy by receiving the R. Charles Harker Policymaker Award from APTA's Health Policy and Administration Section and the Distinguished Service Award from APTA's Academy of Pediatric Physical Therapy. In addition, Moore has written, presented, and lectured on health policy, payment, and government affairs issues to a variety of health care and business groups across the country.


Moore received his doctor of physical therapy degree from Simmons College in Boston, Massachusetts, in 2005, his master of physical therapy degree from University of Iowa in 1996, and his bachelor of science degree in dietetics from Iowa State University in 1993. He was honored by Iowa State University's College of Human Sciences with the Helen LaBaron Hilton Award in 2014 and the university's Department of Food Science and Human Nutrition's Alumni Impact Award in 2011, and he was the Family and Consumer Sciences' Young Alumnus of the Year in 2003. He also recently completed a 3-year term on Iowa State University's College of Human Sciences Board of Advisors. Moore was part of the inaugural Leadership Alexandria class in 2004 and served on the Northern Virginia Health Policy Forum Board of Directors.


Read the full transcript below:

Karen Litzy:                   00:01                Hey Justin, welcome back to the podcast. I'm so happy to have you back. So we have a couple of questions to get through today and we also want to talk about the first half of Graham Sessions. So we are recording live at Graham sessions in Austin, Texas. And I've got a couple of questions for you and then we'll talk about your big takeaways from the morning session here at Graham sessions. So first thing is, and this will probably be addressed at Graham sessions tomorrow, but what is the APTA doing the American Physical Therapy Association doing to address the current needs of physical therapists, physical therapist assistants and students to ensure their membership is quote unquote worth it?

Justin Moore:                00:44                Yeah, it's a great question.  It's a question I get often and unfortunately don't have always a great answer because it is such a personal and passionate issue of how do you find value inside this community of APTA. And as you know, value has two meanings, an economic meaning, do you get a return in your investment? And so we look at the physical therapist and the physical therapist assistant of investing in APTA and do they get a return, so there's an economic part of this question, but there's also a principal part. Do you value APTA? And we'd like to focus on that. And then how can we really engage the physical therapist and the physical therapist assistant and really showing value to APTA and getting value from APTA. And I sort of look at it in Adam Grant's philosophy of give and take, you know, the transactional or economic value is what do you get from APTA?

Justin Moore:                01:38                And then the give is what do you give to APTA? We're really blessed by our members giving to us and increasing the value for all. And I think the value at the end of the day, the take home value that PTs get from APTA is we're an unabashedly, aggressive about increasing the opportunities for physical therapists. So if you believe in that mission and that value, how do we continue to connect you to your colleagues? How do we continue to build a community that's going to make this career you've chosen make a difference in people's lives, but also return a fulfilling career to you. And so get that return on investment and that value. So, another thing I'll just tie is our board of directors has been really aggressively looking at how do we continue to be relevant to the next generation of clinicians. And we know healthcare is changing. We know business is changing and we have to be getting better at being relevant at the point of care. We have to get better at promoting the value of our profession and we have to get better at connecting our experts. And right now, I think that's what our strategic planning process is about, is how do we become more relevant to those individual clinicians and professionals.

Karen Litzy:                   02:50                And I think that's different from a couple of standpoints. One and we’ll probably talk a little bit about this tomorrow, is that APTA is obviously a macro organization. There's 101,000 members. So how do you incentivize members from one not dropping off, So a retention issue, right? And two, how do you attract them in to have that feel of more of a micro organization? Right? Cause it's all about the details and it's all about incentives.  So how can the APTA, which is a very large organization and it needs to be that way. It can't be small. So how do you give a macro organization a micro feel?

Justin Moore:                03:35                Yeah, absolutely. It's our greatest challenge. And I think, you know, one of the things that is very good about APTA is we interact with probably 95% of potential members in a five year period. So we have 80% market share of students, 30% market share of practicing professionals. It's a little less than 10% of physical therapist assistants. So we do engage with almost our entire community over a five year period. But we have to return value in the short term to keep them a member. And the greatest challenges that is, how do you let this very diverse clinical community, how do you build a spirit and harness the power of inclusion? So people can find their people so they can find their community inside this large network of professionals. And sometimes APTA has been too complex, too fragmented, and too divisive to achieve that objective.

Justin Moore:                04:29                And so we have to look at those themes on a pretty regular basis is how do we become more inclusive? And so how do we help people find their people, their network of individuals, because they're going to get great value in that if they're going to be a better private practitioner, if there going to be a better pro Bono clinic operator? If they can connect to their people that's going to return value, how do we reduce the fragmentation? We all are committed to promoting the value of PT Well, if we're talking about the value of a certain part of PT, we're constantly competing inside the PT world. It really dilutes our impact. And we know that from data is we're a pretty fragmented community. And so we've got to reduce that fragmentation and build unity. And have to be better working together.

Justin Moore:                05:17                We're not unified.  The bigger you get, the harder it is to feel the intimacy. We had a consultant work with APTA’s board one time and he put up a matrix.  He said, you can be three of the four things in the quadrant, but you can't be the two things that are across from each other. And the two things that cross each other in that matrix were intimacy and strategic. And so to be a strategic organization, can you still be intimate in an association of one where you address every need, every one, and we have to figure out, we're going to be a complex organization, but we have to figure out how to give an intimate experience, but be strategic in that intimate experience.

Karen Litzy:                                           And it's a challenge. It's a challenge for a large organization, but it's good to hear that that's on the minds of the people at APTA.

Justin Moore:                06:06                Yeah. I think we've realized that we have fallen short at times of really being able to connect people, really giving people a sense of inclusion. Even though we've tried to be inclusive. If it is not conveying that to the end user or member and they don't feel included then we're missing the mark.

Karen Litzy:                                           One thing it's not about is the money.

Justin Moore:                                        We can give you in economics, I always tell the story is, you know, it is a federated model, has a complex new structure, but APTA dues are 295 in the realm of that, it's a pretty low price point inside of professional associations.  If you compare us to other medical associations, other nursing professions, it's a pretty low price points. We probably return economic value for transactional value to the member, and show that value pretty well. But if they don't value their experience, it doesn't matter what the price point is. And so that's what we really have to work to achieve.

Karen Litzy:                   06:59                Yeah. Not Easy. I look forward to seeing what comes out in the next couple of years there. Okay. Moving on. If you can end with, maybe we already said this a little bit, but if you can change one thing about the APTA organization, what would it be and why?

Justin Moore:                07:13                I think it would be to harness the power of inclusion. We've really been focused on that and how do we create a community that at times has been competitive or fragmented and how do we bring them together for commonality and unification around promoting the value of PT, promoting the brand of PT and we're going through a process right now at APTA of rebranding and we're going to be launching that in the next 12 months. And what we found is we went through the research on doing that is we're conveyed way too many opportunities to put your own perspective of what the value of PT is. And we need to really get unified and more inclusive in that march toward promoting our value.

Karen Litzy:                   07:57                Simplify the message a little bit more.  It is hard because within physical therapy you have so many options of workplaces and how you work and who you work with and states and personalities. And I mean the list can go on and on. I would imagine having that sense of inclusivity among 101,000 members, but 300,000 PTs across the country is not easy when everyone is so diverse, diverse in race, religion, gender and diverse in practice settings. So it's like you have to not be, I'm trying to do everything but a master of none.

Justin Moore:                08:43                If you're trying to do everything, you're actually doing nothing. That's sort of been a challenge for APTA. They're trying to be all things to all people and was at times maybe a little bit mediocre at everything. So we really have to do that. And I think the common theme is we've done some analysis both on the data side and then actually a social listing. And two themes come out about the PT community is we're pretty divisive. So when you guys see this is people like to tear other people down or can say that they're better at a certain thing than others. So if we could get away from that divisiveness and correct that, that would be great.  If an outsider was looking at our dialogues, it would not be a positive experience. 

Karen Litzy:                   09:36                I’ve had a patient tell me like what you guys really don't get along.  I’ve seen some conversations on social media. And I was first of all shocked that a patient would actually bring that up so people are looking and they are reading.

Justin Moore:                09:44                We've had outside consultants that have look at this and they said they can't believe two things. How some of our acting members tear us down. And so these are people who have already made a decision to join us but yet like to tear down the organization. And then what we found is when we were out looking at the research on our next strategic plan and looking at net promoter scores our highest distractor group, was some of our longest serving members, and essentially we figured out we're not engaging their expertise well enough. And so that was sort of a wake up call for us instead of saying, oh, why are former leaders tearing us down? We said, wait a minute, they're feeling lost. They're feeling not included. They have given a lot of time to this association and now they feel like they've been dropped off a cliff. And so how do we give them a parachute, how do we give them a glider? What can we do to keep them in the spirit of inclusion?

Karen Litzy:                   10:36                I think that's great because you know, in some conversations I had yesterday, someone brought up to me that it was really great and it was that the APTA has 101,000 quote unquote experts. So the organization is not the expert. They're the facilitators of all these experts that they have at their fingertips. And just think how much the organization can do by being a stellar facilitator of all those experts.

Justin Moore:                11:05                APTA is a vehicle. We don't practice, we don't do research, right? We don't do, we do a little bit of education. We do a little bit for professional development, but we can be a vehicle where our educators can educate, our researchers can publish, our researchers can have access to funding and our practitioners can get that. So we have to really leverage our role as convener. Our role as networker. As a funder. The very basic principle of association is people come together for collective success. So they give us dues you use to put into a collective operation for PR, for advocacy, for all those things. And we've got to get better at that. Include that spirit of inclusion.

Karen Litzy:                   11:46                Perfect. Alright, next question. So the World Confederation of PT Conference is coming up in a few months in Geneva in May. So how is the APTA improving its outreach and involvement in the international world of physical therapy? Are you going to be in Geneva?

Justin Moore:                11:54                Yeah, it's a big priority for APTA to be an international partner and contributor to global PT. And so WCPT is one part of that. It's not our inclusive effort. But APTA has a long history of involvement with WCPT including being one of the founding countries and including having at least a couple of presidents I believe. So, most recently, Marilyn Moffat was president of the WCPT. So we have a longstanding commitment and contribution to WCPT and the conference in Geneva will be a great community of international leaders where we can go and be in a posture of learning. So a lot of times we're not going to, we go and have a delegation at WCPT, but we're really going to interact with our colleagues in Australia and the UK and the Netherlands and really learn from their successes and how we can apply those back here.

Justin Moore:                13:01                I think this morning at the Graham sessions when we heard T.R. Reid and it's a great book. I highly recommend it, but he went around and experienced healthcare in different countries.  That's sort of what we do at WCPT. We go and we talk to the Netherlands of how did they stand up their registry? How did the UK be frontline in primary care, how did Australia get this great expertise in sports and orthopedics and manual therapy? And so what can we do to really leverage that global community to improve care back in the US as well.  WCPT is just like APTA, it’s an organization. And so we have a responsibility as a member. It's interesting, WCPT doesn't have members that are individual physical therapists. Their membership is the organizations that comprise the countries.

Justin Moore:                13:49                And so we are one of about over a little over a hundred member organizations at WCPT and we, you know, we take that responsibility very seriously and always are looking for opportunities to contribute to their objectives and especially when they're aligned with our objectives.

Karen Litzy:                                           I’m looking forward to going to Geneva. I can't wait. I think it's going to be awesome and I'm actually going to be staying with some international PTs. So one from Canada and one from Ireland. I go to a lot of international conferences. It has really changed the way that I practice, it has changed my outlook on the profession as a whole. And what you find when you talk to therapists from different countries, we're not all that different. The way we practice, the challenges that we all have in these different countries are very similar. And I found that to be very eye opening.

Justin Moore:                                        As a physical therapist who's gone into association management, I've gotten huge value from some of my colleagues of other physio therapy associations.

Justin Moore:                14:46                So Cris Massis at the Australian physiotherapy association, he's just been a great role model. Someone to learn from. And it's nice because it's safe. You know, we're not competitors. He's got his lane. I got my lane and he's been a great resource. Mike Brennan, who was at the Canadian Association a few years ago has been a great reference and resource and I've just been able to observe a lot of these international CEOs and how they conduct their business. And it's been a great learning opportunity for me as well, a little different clinic than the practitioners.

Karen Litzy:                   15:20                The parallels are there and the APTA, we’re as clinicians trying to learn from each other and as heads of organizations you're trying to learn from each other.

Justin Moore:                                        It's one of the strongest things is the opportunity to interact with those other CEOs.

Karen Litzy:                                           So before we finish up, what were your biggest takeaways from the morning here at Graham sessions?

Justin Moore:                                        Well, I thought my biggest takeaway, or I don't know if it’s a takeaway or my biggest observation is a lot of thought provoking conversations are already starting. And this concept, and we're going to face this all the time, this concept of what is next in healthcare reform that was started by a T.R. Reid’s presentation, but also what does that mean for physical therapy and where do we need to change our lens? Where do we need to change our focus and how do we need to adapt to be part of the solution, not part of the problem was a key theme. There's a lot of brains in that room, and so I'm looking forward to how they process over the next several hours and come up with solutions. It's easy to point at the problems, but the solutions are always more complex.

Karen Litzy:                   16:29                So thank you so much for coming on.




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Mar 14, 2019

On this episode of the Healthy Wealthy and Smart Podcast, Jenna Kantor guest hosts and interviews Jim Dunleavy on the New York House of Delegates.  Jim Dunleavy is Chief Delegate of the New York Physical Therapy Association Chapter.  James Dunleavy graduated Cum Laude with a Bachelor of Science in Health Education from Manhattan College in 1976. He received a P.T. Certification in 1977, followed by his MS. P.T. in 1983 from Columbia University. James was a Co-founder and acted as its first President of the Acute Care Section from 1992-1997. He served as an APTA Director from 1998-2004 and received the APTA‘s Lucy Blair Service Award in 2005. Currently, James is the President of the New York Physical Therapy Association, an office he took in 2006.

In this episode, we discuss:

-What is a motion?

-An overview of how the delegate assembly functions

-Jim’s advice for new graduates who are looking to get involved in professional organizations

-And so much more!



Jim Dunleavy Twitter

New York Physical Therapy Association


For more information on Jim:

APTA spokesman James M. Dunleavy is administrative director of Rehabilitation Services at Trinitas Regional Medical Center in Elizabeth, New Jersey. He also serves as adjunct faculty in the Transitional Doctor of Physical Therapy Program at Rutgers University. As an active member of APTA, he founded the association’s Academy of Acute Care Physical Therapy and served as its president for 5 years. He has held various volunteer positions within the association, including serving as a director on the APTA Board of Directors. Dunleavy also has held many volunteer leadership positions on APTA’s New York Chapter Board of Directors, including treasurer, district chair, district director, and president. In 2005 he received APTA’s Lucy Blair Service Award. He was the first recipient of APTA’s Acute Care Section Leadership Award, now named after him. He received a bachelor’s degree in education from Manhattan College, a master’s degree in physical therapy from Columbia University, and a doctor of physical  therapy degree from Massachusetts General Hospital Institute of Health Professions.


For more information on Jenna:

Jenna Kantor (co-founder) is a bubbly and energetic girl who was born and raised in Petaluma, California. Growing up, she trained and performed ballet throughout the United States. After earning a BA in Dance and Drama at the University of California, Irvine, she worked professionally in musical theatre for 15+ years with tours, regional theatres, & overseas ( until she found herself ready to move onto a new chapter in her life – a career in Physical Therapy. Jenna is currently in her 3rd year at Columbia University’s Physical Therapy Program. She is also a co-founder of the podcast, “Physiotherapy Performance Perspectives,” has an evidence-based monthly youtube series titled “Injury Prevention for Dancers,” is a NY SSIG Co-Founder, NYPTA Student Conclave 2017 Development Team, works with the NYPTA Greater New York Legislative Task Force and is the NYPTA Public Policy Committee Student Liaison. Jenna aspires to be a physical therapist for amateur and professional performers to help ensure long, healthy careers. To learn more, please check out her website:


Read the full transcript below:

Jenna Kantor:                00:00                Hello, this is Jenna Kantor with Jim Dunleavy who is the NYPTA chief delegate. And I am very excited to be interviewing this morning. So first of all, thank you so much for agreeing to be interviewed on the wonderful, healthy, wealthy and smart. So delegate, chief delegate. Would you mind explaining what that is for anyone who does not know and what that is related to within the New York Physical Therapy Association?

Jim Dunleavy:               00:30                Well, the chief delegate actually leads the delegation from New York to the national house of delegates each year. I'm basically the organizer. I do the assignments of motions. I hold webinars and phone calls with the delegates during the course of the year to get them up to speed with the issues that are facing us that are brought before the house of delegates each June.

Jenna Kantor:                00:58                Yeah, it's excellent. And I'm on that email list and so I'm always just going reading, having different physical therapists help transcribe it for me. So thank you, you just are so good at keeping us up to date with that. So for you, I'm just wondering on a weekly basis, how much time do you need to put into your job?

Jim Dunleavy:               01:17                I would say it varies. It gets more as we get closer to the house of delegates each June. The APTA has gone through kind of a metamorphosis and has created almost a year round type of governance process. So, the motions are starting to be brought out in concept form, usually early in the fall. In the past it's just been we get it in March, we read it, we go to the house, that's it. But now we have to really look at it almost as a year round job to keep people on top of it. Make sure we see what issues are coming possibly before the house. And giving our input from New York as to how we feel about these motion concepts and then the full blown motion will affect us in New York.

Jenna Kantor:                02:15                So when you're saying motion, what do you mean by motion? Is that a new law? What is that?

Jim Dunleavy:               02:20                We run a house of delegates. It's similar to a mini Congress or a mini house of Representatives. And so the issues that come before that house have to be in the form of a motion, which is a clearly defined statement, whether it be a policy, whether it be charging the APTA to do something, whether it be a philosophical or sociological position. And the group will review it, they will discuss it, they will argue about it and then they will vote on that motion.

Jenna Kantor:                02:54                Oh, so it's like when it goes to the Senate or Congress. So if I was to think of the school house rock video where they're singing, I'm just a bill. Do you like that reference? Yes, but honestly, that's where my brain needs to go cause I'm massive beginner with this. So I right now I'm an alternate, which I'm very just honored to even be an alternate for the possibility of going. So I was wondering what is it like, let's say day one at the delegate assembly? Is it just people just kind of, you know, is it, how are things brought in order? Is there an introduction? Are there, is there a ceremony with candles and, and you know, it was some sort of like traditional dance. What happens on day one at the delegate assembly?

Jim Dunleavy:               03:49                The candles and the dancing, that's a good idea. Maybe we'll get them going a little bit more. First two things. One, you mentioned the term delegate assembly. The delegate assembly is actually New York's own little congress, little house of Representatives. What I'm chief delegate of is the delegation of New York that goes to the national house of delegates. So in New York, we're a little different than other states. We have 10 districts. We have representatives from each of those districts come to our delegate assembly, usually in April or May, where we review all the things that are going to come before the house of delegates plus vote on any bylaw changes or other issues that are going on in New York state alone. In terms of how it's structured, you have delegates are voted upon to go to the house of delegates by our delegate assembly.

Jim Dunleavy:               04:51                So that's one set. Then in addition, each district has the ability to designate one person. So there's 10 and then whatever is left in the order of the voting in the delegate assembly, those people are on our alternate list. So, believe me, it happens every year. We have people who drop out for various reasons. In fact, I have one right now that I have to replace, so I don't know where you were on the list, but you might be getting a call from me later. I have to keep track of that and I have to constantly update the APTA delegate list and the chapter deligate list. So they get all the information that they need either as now an active delegate and not an alternate.

Jenna Kantor:                05:44                If somebody was an alternate, like my situation and then I'm down at the end of the list. But I'm also, honestly, I really am grateful to be on the list especially as a new Grad. So I'll take it, so if I was able and fortunate enough to, you know, be able to fill in for someone, does that make me for the next year as a regular delegate or am I still considered an alternate?

Jim Dunleavy:               06:10                The delegation is a one year service time. So we will vote this coming April I think is the delegate assembly. We will vote for the delegates going to the 2020 house of delegates. This group of delegates that are going to Chicago in June of 2019, they were voted upon last delegate assembly. So it's a one year cycle. We've actually talked about changing that to maybe get a little bit more experience in four people. So we're talking about maybe changing the bylaws to two years of service. I'm not sure yet, but it is a one year service time.

Jenna Kantor:                06:58                Okay. Very good to know. Alright, so let's go back to day one. So we're at the house of delegates day one. So apparently there was no dancing ritual.  So what is the order usually on day one at the House of delegates?

Jim Dunleavy:               07:24                For the New York chapter, what we usually do is our delegation comes in usually the day before the house opens. And I usually try and hold a, what we call a caucus meeting to just orient everybody, go over any changes that I'm aware of and in any of the motions, prepare the delegates for the next morning, which are the interviews for people running for national office because the house of delegates is the voting body that votes for president, vice president and so on. We have interviews of those candidates all morning and we have I think four rooms or five rooms that we have delegates in who asks these candidates questions, we will then come back as a delegation together. We will talk about the candidates, make our selection and then start to work on the motions. Then after that, usually in the late afternoon, early evening, the house of delegates starts and it's a pretty impressive place if you've never been there because you have over 400 plus of your colleagues from around the country sitting in front of a large dais with the speaker and other officers there. And we run a parliamentary rule meeting with the idea of making the best decisions for the profession in the United States.

Jenna Kantor:                08:53                This is honestly very exciting to me as much as I'm calm as I'm saying this, like it's just, it's getting my heart beating and I'm like, I want to be there one day.  This is just a random, silly question, but Lord knows anyone who knows me, I love random silly questions. So if I was to be interviewing for any of these amazing higher positions, that can make a great difference. If I did the splits or broke into a song and dance, would that help my position or possibly pull things back or maybe would you cast me in a Broadway show instead?

Jim Dunleavy:               09:24                I'd probably go with the Broadway show. Probably doing the song and dancing in an interview here, I don't think the culture would really take to that very well. I think though that the culture in the interviews is changing with the age of the delegates. We talk a lot about millennials. We talked a lot about all of them, gen x’ers and everything else. And how we have to change our communication style in order to reach out to our newest members and future leaders. I've seen a change in culture and that it's a little bit lighter, but I don't think we're doing the song and dance just yet in the interview process.

Jenna Kantor:                10:18                So no Hamilton rap? No, no, no. Okay. Okay, good. Just good to clarify it. In the hallway, right to take care of those nerves. So when going in the rooms, this honestly reminds me cause I have the musical theater background of auditions. It really does. So for you guys on your end, as you are interviewing these people, I mean aside from the buckets of coffee that you're probably having to just stay really focused. You really need to see that people are right for these positions. Do you try to make it a friendly environment or like what kind of environment are you trying to create to help that person who is being interviewed?

Jim Dunleavy:               10:59                Well, I think we're trying to make it a level playing field because what we have done is we have agreed to do a set questions in every room so that the delegates that are in each room gets to hear each candidate's answer to the same question. Then each room does have an opportunity to ask some of their own questions. So when I ran for APTA board and I had to do these interviews myself, that was not the case. I had no idea what was going to be thrown at me in terms of questions. You could be asked anything. I think now it's at least fairer, it's a level playing field for the candidates. They know they're not going to get any serious kind of Gotcha questions cause we went through a period of time where people thought that was fun. So I think it's a much easier experience for the candidate then perhaps maybe it was when I ran. I think people still get insights into these people.

Jenna Kantor:                12:16                Absolutely. And for working with your team when you are discussing, cause you're saying people are in different rooms, you know, you have the different rooms and are you guys all, is it say Melanie goes in, she gets interviewed in one room. Does she get sent to the next room and the next room? So all three groups interview?

Jim Dunleavy:               12:37                Yes. The candidate will get a schedule for the morning, what rooms they have to be in.  So usually very close to each other

Jenna Kantor:                12:48                And muscle relaxers. Anything for the nerves, right?

Jim Dunleavy:               12:51                Absolutely. Yeah, there is. And there is a candidate's lounge where they set up food and coffee and everything else. So you have a place to go and cry when you mess up in the interview. It really is a very well oiled machine how they do it. So what I'm going to have to do as chief delegate, I'm going to have to basically divide up our delegates equally for each room. And then I'm in one room with what we call the Northeast Caucus, which is all the states, pretty much in the northeast. But they'll be New York delegates probably somewhere in the neighborhood of six or seven, maybe eight in each room. So they can hear the differences in the different questions and then I will bring them all back together after the interview session and go through that and make sure that everybody hears what was said in every room by each one of the candidates.

Jenna Kantor:                13:48                Oh, that's so smart. Yeah. I really like how you guys have a system because that's not easy to even develop that system that works for everyone. So I think that's really, really cool how you guys have that organized. So you're done with all these interviews, you have to decide that night for that or was that during the whole weekend that that's part of the house of delegates?

Jim Dunleavy:               14:09                It used to be much more laborious until we went to electronic voting. So after the day of our interviews that evening, the house will open and one of the first orders of business is that we will all vote on the candidates. And then at the close of that session, which is usually around eight o'clock that night, the results are posted both outside the house of delegates room. And on these huge screens that we have in the house of delegates proper.

Jenna Kantor:                14:40                Wow. Wow. Well organized. So you've done the interviews and now we're at lunch.

Jim Dunleavy:               14:49                Up to the interviews, I bring my delegates back to a caucus room that I've got assigned and we start to talk about the candidates and start talking about the interviews.

Jenna Kantor:                15:02                Okay. And then after that discussion, what's after that?

Jim Dunleavy:               15:07                Then later in the afternoon, we're going to have what we call motion discussion round tables where chief delegates and some delegates if they want to come, can come. But we come and discuss strategy issues and or changes in motions, get more information on particular motions that are going to come before the house. And usually we have two or three of those in the course of the days that we're together. So that once we get to the floor as many of us as possible, have the same information about a particular motion.

Jenna Kantor:                15:44                Oh that's so great. So you can get on the same page. That's brilliant. I really liked that. That's so smart. And that's the new thing you were saying.

Jim Dunleavy:               15:50                Well we used to do it a different way. We used to have these called motion discussion groups where motions were assigned to a room and then you would run around and trying to listen to the information that way. We're going to try these round tables where I'm assuming it's going to be set up, like each table is going to be a motion and you could go to whatever one you want, and just do that for a period of time. I think that's a good change.

Jenna Kantor:                16:18                I love that. I like how you guys are always trying to fix a problem, solve and improve. That's really incredible. And then we get to the meeting after everybody's on the same page. Everyone understands what's going on. Everyone then comes together. There's that vote at the beginning, right, like you said. And then is it all run by Robert's rules?

Jim Dunleavy:               16:39                Yes. Everything we do is via Robert's rules. We have a speaker of the House who's basically our facilitator, making sure everything moves forward as quickly and efficiently as possible, but also within the realm of Robert's rules of orders. So everybody is dealt with in a fair way. We don't want people, we have very small states. For example, we have states that may only have two delegates there. New York is a larger state. We have 25 delegates. So if you're looking to influence votes in order to get something passed, you're generally going to try and go to the California's, the New York's, the Illinois’, the Florida’s, the Texas’, to try and garner as many votes as you possibly can for whatever issue you're trying to support. So the smaller states need to have protections. And so I think the caucus process of them being assigned to the caucuses from throughout the United States, they get much better information before they meet because then they're just not talking amongst themselves and they also have the ability to create relationships with some of the larger states. So we all know what everybody is doing.

Jenna Kantor:                17:57                What do you mean by caucus? Would you mind defining?

Jim Dunleavy:               18:00                There are caucuses set up throughout the United States. The one New York is in is called the northeast caucus. It's actually the oldest. We have states from Maine down to DC, I think it is on the east coast.

Jenna Kantor:                18:17                Oh. So it's like a region essentially?

Jim Dunleavy:               18:19                It’s a regional Caucus. Now that caucus does not have any authority in terms of voting. We don't block vote. We don't try and get everybody together and vote one way at a particular issue. That's not the purpose of the caucus. The purpose of the caucus is to share information, to perhaps bring a motion concept like I did with the New York motion this year to the caucus to get viewpoints and ideas. And perhaps as a caucus, ask for information, ask for changes in the way we do things, and send that to the house officers. So it's an information gathering, sharing and actually very stimulating meeting. We have one in the fall and we have one in the spring, and we have one here. We had one here the other night, so we're looking I think in March or April to have one. It's up in Vermont, I think. And then the one in the fall, I don't remember where that one is, but basically it is part of a year round governance process where we'll be talking about motion concepts at all of these.

Jenna Kantor:                19:38                And for those who don't know, we are actually at the combined sections meeting, which I did not say. So when he's referring to here, he's talking about here in DC 2019. Yes, yes. This is excellent. So during Robert's rules, how was it handled for someone who's new and they're not familiar with what even Robert's rules is? Is there somebody who teaches them when to raise their hand or say a motion or a vote of where somebody to just make sure, for lack of a better word, that they're in line?

Jim Dunleavy:               20:16                It can be intimidating the first time for a new delegates especially when they first walk into the house and they see the physical enormity over get it. You don't get a sense of that until you're there. It's also very, I find it very exhilarating to have all our colleagues together in one place. What APTA does, it's a PowerPoint slide presentation to orient new delegates to the process. We have an orientation handbook in New York where I do a conference call and we're probably going to move to a webinar format next time, with all the new delegates each year. So I basically go over what their role is, what to expect, some of the mechanics of what they need to do. And even with that, I know some of them are still not totally clear, we did that in November. And so I'm still getting questions. So, the good part is I'm getting the questions. In the past, I remember when I was a new delegate, we had no such orientation. It was, here you go and you're done and you just deal with it.

Jenna Kantor:                21:42                Oh, just praying that you just rose your hand the correct way.

Jim Dunleavy:               21:47                Exactly. Right. They do have a lot of resources now. In New York, we usually buddy up, the new delegate with an experienced delegate. So if they feel for whatever reason, they don't feel like you can find me or talk to me, they have this other person that they can reach out to.

Jenna Kantor:                22:09                Yeah, that's wonderful. I definitely could see myself wanting to lean over and be like, what are they talking about? And you know, would you mind defining this? So I think that is a great thing that's already in play to get that mentoring. I could definitely imagine myself, and this has been advice from others that the first year, not that  I wouldn't vote on things, but to spend more time just being quiet and listening because there's so much to take in. Would you agree?

Jim Dunleavy:               22:37                Absolutely. It takes time to get used to the process. And so you have to, early on as a new delegate, you have to spend your time dealing with the mechanics of what's before you. But there are also situations where new delegates may feel very passionate about a particular issue that's coming before the house. And so how we've done it in our chapter, is we've tried to keep it as open as possible. I do not restrict our delegates from getting up and having their say at the mic. And what I have noticed is I think the newer delegates are much more better equipped, I guess the best way to handle that situation. I know in the past and I was one of them, the first time up to the mic in front of 400 of your closest friends can be a little intimidating. I've seen with our newer delegates, a much higher sense of confidence in and a knowledge base and again, the passion that they bring. I think we're going to have a number of delegates here in New York for many, many years to come that will be great representatives of the chapter.

Jenna Kantor:                24:06                I love hearing that. It's very exciting. I'm so grateful to have somebody like you in New York who's really leading us with such clarity. And I just want to thank you. Thank you. Thank you. Thank you for coming on to this podcast because this is going to be a resource that I'm going to be sharing out with people who are interested, a lot of students for sure. Cause I'm definitely, even though I'm still a new Grad so I still have that, you know, flowery perspective. So for you to take the time and sit with me on the last day of CSM when we're very exhausted. I am truly grateful. So thank you Jim Dunleavy for coming on. Do you have any final words of advice you would like to give to anyone regarding the house of delegates?

Jim Dunleavy:               24:50                Well, I would just say for everyone to get involved. In New York you have multiple places to get involved. You can get involved at your local district level. That's where I started. Somebody invited me to a meeting and here I am years later doing these types of things and also having served in national office and creating a section. It's been a wonderful, wonderful part of my career. You always get paid back 10 fold, what you give. And so I would say get involved. Call the chapter, call your local district representative, find out when the meeting is locally, and start that process there because the thing that drove me was going to a meeting that a friend brought me to actually when I was in PT school. And I left that meeting thinking I do not want these people making all these decisions without me talking about this. And that was kind of my driver. You know, people have different drivers, but I think get involved because that's the only way the profession is going to move forward.

Jenna Kantor:                25:58                Thank you. Thank you so much. Those are excellent words of wisdom. Thank you for coming on.



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Mar 11, 2019

On this episode of the Healthy Wealthy and Smart Podcast, Jenna Kantor guest hosts and interviews Karen Litzy on her journey to become a leader of the physical therapy profession. Karen Litzy, PT, DPT is a licensed physical therapist, speaker, owner of Karen Litzy Physical Therapy, host of the podcast Healthy Wealthy & Smart and creator of the Women in Physical Therapy Summit.

In this episode, we discuss:

-How Karen started her career in New York City

-The importance of relationship building to grow your practice

-Why you should say yes to things that align with your values

-A sneak peek at the Strictly Business Mastermind

-And so much more!



Karen Litzy Twitter

Karen Litzy Instagram 

Karen Litzy Facebook

FOTO Outcomes Summit, use the discount code LITZY


For more information on Karen:

Dr. Karen Litzy, PT, DPT is a licensed physical therapist, speaker, owner of Karen Litzy Physical Therapy, host of the podcast Healthy Wealthy & Smart and creator of the Women in Physical Therapy Summit.


Through her work as a physical therapist she has helped thousands of people overcome painful conditions, recover from surgery and return to their lives with family and friends.


She has been a featured speaker at national and international events including the International Olympic Committee Injury Prevention Conference in Monaco, the Sri Lanka Sports and Exercise Medicine Conference, and various American Physical Therapy Association conferences.


Karen has been featured in magazines and websites like Redbook, Women’s Running, Martha Stewart Living, Family Circle, and CafeMom. She has been a guest on several podcasts including Entrepreneur On Fire, Hack the Entrepreneur, and The Healing Pain Podcast. She lives in New York City.


For more information on Jenna:

Jenna Kantor (co-founder) is a bubbly and energetic girl who was born and raised in Petaluma, California. Growing up, she trained and performed ballet throughout the United States. After earning a BA in Dance and Drama at the University of California, Irvine, she worked professionally in musical theatre for 15+ years with tours, regional theatres, & overseas ( until she found herself ready to move onto a new chapter in her life – a career in Physical Therapy. Jenna is currently in her 3rd year at Columbia University’s Physical Therapy Program. She is also a co-founder of the podcast, “Physiotherapy Performance Perspectives,” has an evidence-based monthly youtube series titled “Injury Prevention for Dancers,” is a NY SSIG Co-Founder, NYPTA Student Conclave 2017 Development Team, works with the NYPTA Greater New York Legislative Task Force and is the NYPTA Public Policy Committee Student Liaison. Jenna aspires to be a physical therapist for amateur and professional performers to help ensure long, healthy careers. To learn more, please check out her website:


Read the full transcript below:

Jenna Kantor:                00:00                Hello, this is Jenna Kantor interviewing for Healthy, Wealthy and Smart. And I am here with the founder, the original Mama Jamma, Healthy, Wealthy and Smart Karen. And I am going to be a major fan girl. No apologies for this at all because I've been wanting to interview Karen for a long time because she is just one of the most inspirational people in physical therapy. And I would say honestly amongst women and physical therapy, the leadership that you take is absolutely incredible and I appreciate you agreeing to coming on. So thank you.

Karen Litzy:                                           Well thank you. And I think this is the first time I've been interviewed on my own podcast. I think so unless you count the time Bronnie Thompson was asking me questions and made me cry. But for the most part, this is definitely the first time.

Jenna Kantor:                00:51                Not a meltdown in this one. Well what I'm really excited about as so anybody who is a fan of Karen lets you see all that she does. This is to really learn about her backstory and also how possible it is to get to where she is at now. So one thing we were talking about the other day, Karen, as you were saying, how you moved to New York and you knew no one, I would love for you to expand upon that and how you took those steps to knowing everyone.

Karen Litzy:                                           Well, so when I first moved to New York, I knew my roommate because we had gone to high school together and maybe two other people that we went to high school with. And what I decided to do when I first moved to New York is I couldn't find a physical therapy job that I felt like it was a good fit.

Karen Litzy:                   01:43                And so I ended up working at what was then called Reebok Sports Club. It's now an Equinox, but it was this sort of a country club in the city. So it was a very high end, very expensive gym. So I started working there as a personal trainer. And because of that environment, there were so many personal trainers, Pilates instructors, nutritionists, not to mention all of the people who go in and out of the gym and all the clients I was lucky enough to work with. And because of that I was able to meet hundreds and hundreds of people. And to this day, those trainers, the people who work, like a computer program there for children, there are nutritionists, pilates instructors. To this day they still refer patients to me. And that was wow, 18 years ago. So, you know, we talk about building relationships and how important that is.

Karen Litzy:                   02:41                And I think having that as my first job in the city and being exposed to so many different people, I felt like it really helped me build relationships and friendships at this point that have continued to blossom and grow. And I mean, I just had a patient that was looking for a strength and conditioning coach. And so I said, well, I work with one, a person who is amazing. And he was one of the first people I met at my new job 18 years ago. So it was a bit of like an unconventional path for a physical therapist and it's just cause I couldn't find my fit. I couldn't find that niche that I really wanted and maybe the clinic that I really wanted to work at and now that being said, I knew ahead of before I moved to New York that this gym existed and that it was a high end gym and that I would be exposed to a different kind of clientele.

Karen Litzy:                   03:36                I don't know why I looked that up to begin with, but it was because of that, that gave me the idea to go out on my own and to start seeing patients in their homes and home gyms and homes and offices because all of the personal trainers at this gym, we're seeing people outside of the gym. If they're doing that, then why can't I do that? Why can't a physical therapist do that? Why do they only have to come to a clinic in a more traditional sense of the word? So it was because of that first job that I met so many people and those relationships continue to grow other relationships and that I got the idea to do my business.

Jenna Kantor:                04:28                That's incredible. So for you, now that your network has expanded over time, clearly it's like full bloom. Hello, I look at you almost like the Oprah of physical therapy here. So how do you keep in touch or maintain these relationships with all these people? Like what is your skill for that?

Karen Litzy:                                           So as far as maintaining them within New York City, it's pretty easy because we'll get together or you send a quick text. Cause most of these people are my friends and I credit working at that gym and also playing softball in central park that I was able to meet so many people.

Jenna Kantor:                                        You play softball. Hold on, pause, elaborate.

Karen Litzy:                                           So one day I was running in central park and I was like, Ooh, softball. So I went down and I was like, Hey, do you guys allow girls to play? And they were like, no. And I was like, oh, um, okay. And they said, well, what do you do?

Karen Litzy:                   05:16                And I said, well, I'm a pitcher. And then they asked if I was good. And I peeked my head around and looked at their pitcher. I'm like, I'm better than the one you have. And so the next week I went for my tryout and then I became their pitcher. And then the following, summer I was recruited to play in a fast pitch like windmill fastpitch league. So I played there for several years and all the guys that I played with on that softball team, are lawyers, and they have referred patients to me. And you know, you just keep in touch. And so I met my two best friends that way in the city and they refer people to me from a business standpoint, but they're also my friends, you know, and they're part of my lifeblood of being in the city. And so my best advice if you're moving to someplace where you don't know anyone is to get involved in things you like to do.

Karen Litzy:                   06:07                So I love playing softball. So that's what I did, you know, and I loved working out. So I decided to work in a gym as my first job. So instead of kind of pigeon holing yourself into what just physical therapy or just this, just that, like really kind of open yourself up because you never know who you're gonna meet. So in this city it's easy to keep in touch, well, I shouldn't say it's easy. It's not easy, but if it's a priority for you and your life, you make it and you make it a priority and you put in the effort. And so for me, and as you know, Jenna, you keep in touch with a lot of people. You spend your time on networking and on making those relationships. And the best way to do it is to make it a priority.

Karen Litzy:                   06:47                And so I may have, you know, my week is sort of chunked out so I have patient care, but then there's times where I'm like, okay, all I'm going to do is write emails and send messages to people and it's in my calendar, it's write emails and send messages to people just so that you're still in there hemisphere.

Jenna Kantor:                                        You know, it's keeping those relationships. Otherwise it becomes that long lost relationship. Even if when you hang out with them again you could just act like no time has passed. It's still something that needs to be rekindled. So it avoids that.

Karen Litzy:                                           And it's putting in the effort. Like a good friend of mine, his name is Dr. Jordan Metzl who's a physician in New York and he does free workout classes every month. And so I try and make it a point, okay, I'm going to go to one of his classes even though I can't walk for two or three days because my legs are so sore afterwards. But I make it a point because he's my friend and I want to support him and I think what he's doing is important.

Jenna Kantor:                07:37                I love that. I'm sure I've probably seen pictures of you after the workout going, just finished the workout with Metzl right now. I love that. And you actually are tapping upon something that I know we are 100% agree upon is really supporting what other people are doing. Showing up for what they do is a real big part of the networking and how your life and your career has truly grown.

Karen Litzy:                                           Yeah. It's just being supportive of people that you believe in. So going to something like the CSM where there's 16-17,000 people here, like there are people that I want to make it a point that I at least say hello and that I have a conversation with, even if it's just five minutes, you know, because it's important to me and I hope it's important to them, but I know that it's important to me because I want to show up for them and I want to support them.

Karen Litzy:                   08:31                And so that's just what you do if you want to keep your relationships going. And as far as keeping relations with international colleagues, it could just be a quick, a quick note on Twitter or a quick email or hey, I thought about you the other day because I really want to introduce you to this person because I think you guys should at least know each other cause you're doing the same research or you know, I met a colleague in the Netherlands and he has since referred patients to me in New York and he's a physio in London, but you just keep in touch with people and you do good work. And I think that's the best way to keep your relationships going. And it doesn't have to be every day, right? It could be consistent.

Karen Litzy:                   09:24                It takes five minutes. A lot of times I do this when I'm on the bus cause I'm going from patient to patient. So what else am I supposed to do on the bus? You know, so that's sometime when I'd be like, okay, I'm going to make sure that I reach out to so and so in Australia or to this person in Pennsylvania or to this and that's a good time. So I'm lucky in that sense that I have like random downtime. Chunks during my week and you just, if you think about someone, just let them know.

Jenna Kantor:                                        Yeah, it takes seconds. It takes seconds. Okay. So you have your hands on many things which I love about you. So you have this podcast, which is amazing and soaring and now you also have a team working for you with this podcast.

Jenna Kantor:                10:07                You have your own practice, you have the speaking course. What am I missing? You have a course coming up that's going to be helping practitioners, which is amazing. You’re the nominating committee for the private practice section? Am I missing anything? I want to make sure we tap and tap everything. Okay. So you're doing all these things now, did they all come about all at once for you to achieve it? Or did some of them overlap as you were developing them? Oh, and you're working to become a paid speaker. I mean these are a lot of fantastic things, all a hundred percent possible to achieve in a life, but for you achieving each and every one, have some of them overlapped in the process of growing? I would love to hear that journey.

Karen Litzy:                   10:56                Yes. And I also think that one allows for the next and allows for the next. So one event allows for the next event and for the next and for the next or one experience allows for the next. So for instance, starting the podcast many years ago, I took a couple of years off to go back to get my DPT, but starting the podcast had led to credibility and has led to visibility and in maybe some vulnerability on my part. So when people can see that you're being credible and you're being authentic and you're putting yourself out there, they're drawn to that. And so from that, I was invited to be on a proposal to CSM and then that got me public speaking a little bit. And then maybe from that someone sees you, it's like, hey, you know something, I really like this. We should try this.

Karen Litzy:                   11:50                And so I kept saying yes, yes, yes, yes. And to say as a piece of advice, say yes to everything until you can say no, terrible advice. I don't know. It was terrible advice. Awful. So what I started to do, cause I was saying yes, everything and it is overwhelming and you get burnt out and you start to cry and then you don't feel like you have a personal life. And I want a personal life as well. So now what I've started to do is say yes to things that align with your values. Say Yes to things that in your gut it's a hell yes. Because when you start saying yes to things that are like, I guess I should do it, it's a no, like if you're saying I guess I should do it, you don't want to be shoulding things.

Karen Litzy:                   12:30                It's like, yes, I want to do this. Not, yeah, I guess I should do it. And so I think having that in my mind has been able to narrow my focus a little bit more. So it sounds like I'm doing a lot, but it's all inter related.

Jenna Kantor:                                        It's connected.  And I even left out that you have the annual women in PT Summit.

Karen Litzy:                                           But again, that's all connected, right? So I think it started with the podcast and then doing a little bit of speaking and then I really started to enjoy speaking more and more. And because of that I have made that a priority. And for me each year I pick a word that I like to kind of follow my year and to base decisions on and things like that. And so this year it's courage. And so one of the things that I really wanted to have the courage to do was to do more public speaking and to put out a course to help physical therapists create their own private practice and occupational therapists create their private practice.

Karen Litzy:                   13:27                And these for me, takes a lot of courage and planning and things like that. But if you, like I said, I sort of planned my week in little chunks. So if you can do that, you can get everything done. You just have to put your mind to it. And I also as just a FYI on how I manage my time is that I kind of use pomodoros. So a Pomodoro is a concept that's a 25 minute work block. So I'll set a timer for 25 minutes. I turn everything else off. Sometimes I'll put theta wave music on in the background or binaural beat music because that music is supposed to help increase theta wave, excitability in your brain, which is supposed to have, this is all very, you know, but it's supposed to help you be able to block out distractions and help you focus and things like that.

Karen Litzy:                   14:17                It's the kind of music you hear when you're at the spa. And so I will do that and block everything else out. And it's amazing how much you can get done in 25 minutes. Like so if you are full of distractions, yeah, it's going to take you forever. But if you can really focus for 25 minutes, then you can write that blog post in 25 minutes instead of screwing around for three hours. You know what I mean? And if emails come in, like I'm not the president of the United States, like it's not that important. It's just not. I think we're in a world now where everything has to happenmnow. Now, now, now, now. Whereas I mean, I can say, I mean I started my podcast in 2012 and then took a couple of years off.

Karen Litzy:                   15:03                It's 2019 so it's not like it's an overnight success. You know, I started speaking, the first CSM I spoke, it was in Indianapolis, which was, I don't even know how many years ago. So again, this is just been years of work and years of working on your reputation and years of working on myself in order to get to these points. Nothing is an overnight success because you're always laying foundations and groundworks that can take months or years. So I think it's really important for people to understand that.

Jenna Kantor:                                        And habits, habits are a big thing too, because I'm sure it took you a bit to even make this, this 25 minute habit.

Karen Litzy:                                           Oh my God. Yeah, because I love to be distracted. Squirrel. I'd be like, what? I love to be distracted. But it's true. So to be able to do that and calm my mind down to focus on one thing took practice, but just like we tell our patients with like practice your exercises, if you practice these methods, you become better at the methods. It's the same thing.

Jenna Kantor:                16:02                Yeah. I definitely can relate with that. So now for you, what is your next, oh my gosh. I can't wait for you to listen back to this podcast in like a couple of years and be like, what is your next, cause you have, you have things coming up and maybe those will be your next you would want to discuss, but I would love for you to share that.

Karen Litzy:                                           My probably biggest next is the soonest are the quickest next, let's put it that way. The quickest next would be this course that I'm developing for physical therapists and occupational therapists called Strictly Business Mastermind. And it's to help them create their own cash PT or hybrid or if you already have a practice and you're trying to transition out into a cash based practice.

Karen Litzy:                   16:52                So it's really for those two groups of people. And I'm really excited about that and hopefully we'll have that solidified in the next couple of weeks and put that out there.

Jenna Kantor:                                        That's going to be incredible. And honestly to speak to the fact that we don't have a woman and physical therapist yet leading something like this and we need to, it's for anyone. You need to see somebody who you can even visually identify with. So on top of the content that you're going to be providing, which is going to be off the charts, I'm grateful that you are filling a void that needs to be filled in.

Karen Litzy:                                           And I think it's important to know that I'm not teaching this on my own because I don't have the answers to everything. I can't do everything. It's just physically impossible and mentally impossible.

Karen Litzy:                   17:36                Like I can't do it. So I'm lucky to have a lawyer involved. I'm lucky to have an investment advisor involved. And someone who's an expert at SEO and Michelle Collie who's an amazing colleague with like 5,000, no, not really, but like a whole bunch of clinics in the Rhode Island area because these are people who quite frankly are doing things better than I am. And so to be able to share their knowledge with people, I think it's going to be a little bit unique in that space. Because I know I can't do it on my own. And so I asked for help.

Jenna Kantor:                                        And it's okay to ask for help. And honestly, I definitely wouldn't use the Hashtag better together right now for this because it really is, as much as you are taking the lead on it, it is so good to get to work with other people and everybody benefits from it.

Karen Litzy:                   18:26                Of course. Of course. I just feel like that's important for people to understand that you can't do any of this alone. And that if, if you do, you'll burn out, but if you have the wherewithal to find out, well, what are your weaknesses? Like, what are you good at? What are you not so good at? What do you love? What will someone pay you for? And if you can fill that out and kind of connect the dots, then you'll know what you're good at and then what you're not good at. Just find someone else who is. Because you're doing a disservice to yourself and you're just doing a disservice to people who are spending their money and their time to learn from you. So it's all about respecting the audience. And so what I really want to do is respect the audience and give them the best user experience that they can get and meet those expectations. And I'm my harshest critic.

Jenna Kantor:                                        So I think everyone is, I think everyone is their harshest critic. Well, thank you so much for coming onto your own podcast to just share this. I love how you're just so authentic and insightful and just so true to your own story. And I think a lot of people just appreciate that about you and I definitely do. So thank you.

Karen Litzy:                   19:52                Thanks for having me on.



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Mar 4, 2019

On this episode of the Healthy Wealthy and Smart Podcast, Jenna Kantor guest hosts and interviews Sue Griffin on how to be the speaker for the APTA’s House of Delegates.  Dr. Sue Griffin is the Speaker of the House of Delegates for the American Physical Therapy Association.

In this episode, we discuss:

-What are Robert’s rules of order

-The responsibilities of the Speaker of the House of Delegates

-What roles you should seek in order to prepare for Speaker responsibilities

-Why Sue loves the APTA

-And so much more!



National Association for Parliamentarians

 Use the discount Code: LITZY


For more information on Sue:

Dr. Griffin has been a physical therapist for more than 30 years. She has practiced in a wide variety of clinical settings throughout that time, and continues to practice in acute- and long-term care. Dr. Griffin has taught ethical coursework for entry-level and post-professional PTs and PTAs at the state and national level.


Examples of Dr. Griffin's accomplishments include:


Elected Speaker of the House of Delegates for the American Physical Therapy Association in 2014.

Full-time professor for the Physical Therapist Assistant Program at Blackhawk Technical College in Janesville, WI for more than 20 years.

Served on the Ethics Committee for the Wisconsin Physical Therapy Association from 2007-2013.

Chaired the Wisconsin Physical Therapy Association Task Force in 2004, when the Wisconsin PT practice act was updated.


Lead instructor in a PTA program, delivering content in a wide variety of clinical areas. Long-term and

indepth involvement in clinical education. Licensed doctor of physical therapy with a broad background in many areas, including longterm care, acute and rehab spinal cord, acute head injury, inpatient and

outpatient orthopedics and neurology, and amputation. Board certified in geriatrics. Very active member of WPTA and APTA.


For more information on Jenna:

Jenna Kantor (co-founder) is a bubbly and energetic girl who was born and raised in Petaluma, California. Growing up, she trained and performed ballet throughout the United States. After earning a BA in Dance and Drama at the University of California, Irvine, she worked professionally in musical theatre for 15+ years with tours, regional theatres, & overseas ( until she found herself ready to move onto a new chapter in her life – a career in Physical Therapy. Jenna is currently in her 3rd year at Columbia University’s Physical Therapy Program. She is also a co-founder of the podcast, “Physiotherapy Performance Perspectives,” has an evidence-based monthly youtube series titled “Injury Prevention for Dancers,” is a NY SSIG Co-Founder, NYPTA Student Conclave 2017 Development Team, works with the NYPTA Greater New York Legislative Task Force and is the NYPTA Public Policy Committee Student Liaison. Jenna aspires to be a physical therapist for amateur and professional performers to help ensure long, healthy careers. To learn more, please check out her website:


Read the full transcript below:

Jenna Kantor:                00:00                Hello, this is Jenna Kantor with Healthy, Wealthy and Smart. And I'm here with Sue Griffin, which is absolutely incredible. I am just a fan of anyone who is involved with the APTA and really making a change. So would you mind sharing, your the speaker of the House of delegates, would you mind explaining what is that position? I would love to learn.

Sue Griffin:                   00:20                Sure. So speaker of the house runs the house of delegates. So the house of delegates is pretty analogous to like a representative body like you'd have in your state legislature, like the assembly. So, every state chapter gets to elect physical therapists as representatives. And it's the number is based on the number of members they have in their chapter. So we have about 400 every year that together and they kind of look like, you know, if you've seen those old convention things like the long tables and the state signs, I mean, that's kind of what it looks like. It's in these huge ballroom. There is a day is, and so up on the day is, that's where I preside from. And so the speaker stands on the day is and runs the meeting and it's incredibly formal because you can't have 400 people like talking over one another.

Sue Griffin:                   01:09                It sound like, you know, English parliament or something, which we don't want. So that's the state chapter part. And then we also have all of the sections have a representative, the student assembly sends two representatives, the board of directors are there and the PT Caucus. So they all have representatives. They don't have a vote, but they are able to speak and debate and offer motions and things like that. So that's how our association creates positions and policies.

Jenna Kantor:                01:44                So with all these people together, you are leading the meeting? Robert's rules and all.

Sue Griffin:                   01:51                Yes, very, very formal. And so we stick to Robert's rules really strictly because otherwise again, like it would be chaos.

Jenna Kantor:                02:00                Oh yeah, absolutely. And would you mind explaining what are Robert's rules for those who do not know?

Sue Griffin:                   02:06                Everyone knows what. No, I'm kidding. I'm kidding. No.

Sue Griffin:                   02:09                So Robert's rules of order is a specific kind of school of parliamentary process. So there are a couple of different schools, but this is probably the most famous. And so there's literally a book that kind of like a thick little mini Bible and it helps you run a meeting. So it has rules about procedure, like who can speak when and if someone brings a motion, in other words, if they want to take action, they present in a very carefully worded format and then there are processes for how people can change or amend that motion so that you can, it's a way for a group to make decisions.

Jenna Kantor:                02:47                And it makes it easier for everyone else to follow.

Sue Griffin:                   02:50                Right. And the basis is really to protect the voice of the minority and yet still let the majority accomplish their will.

Jenna Kantor:                03:00                I love that kind of the whole purpose of it.  And what is the time commitment for your position?

Sue Griffin:                   03:05                It varies a little bit, but there's kind of a low level steady level of commitment that's probably five to 10 hours a week because I also serve on the board of directors, so I have to participate on all the board activities as well as manage the house activities. And then like times like this, like pretty much from January through June. So the house of delegates right now is always in June, so pretty much from January to June, or at least CSM to June is when people are really working hard on their motions and we're trying to help them craft them. And so I would say the time commitment is, you know, probably 15 to 20 hours a week.

Jenna Kantor:                03:45                That's great. That's great. Well, you're making a big difference, so that makes sense. And then of course as it gets closer, I'm sure it increases.

Sue Griffin:                   03:52                It does. I don't know that I'm making a big difference. I think I'm helping everybody make a big difference. Now, I'm going to think I'm trying to just, you know, I'm the facilitator. I'm not the, I'm not the maker.

Jenna Kantor:                                        Yeah, yeah, absolutely. So as the facilitator, why do you like this job?

Sue Griffin:                                           Oh, it's just great. I mean, first of all, it's just so many passionate and really smart people, you know, coming together and they all have such great intent. I suppose every process like this is political to some extent, but you know, we don't have, everybody is really trying to move and accomplish what they really believe is best for the profession. And I feel like we really have a group that shares common values at a really deep level. And it's just so exciting to see those people come together and be able to accomplish things because physical therapy is the best profession. Right? And so for us to be able to do things that can help us elevate our level of practice, get people to access us better. I mean that's the kinds of things that you know our association is trying to drive to do. And this is, this is a big part of that. This is the driving body in many ways.

Jenna Kantor:                04:59                Oh absolutely. That's honestly why I love the APTA personally. So for you, what past experiences greatly contributed for you being able to handle and take on this position? I would love to hear your journey.

Sue Griffin:                   05:12                I think a really formative part was when I served as the secretary of our state chapter in Wisconsin and I did that role for four years and you know, secretaries have to take minutes. And so, you know, you're in a meeting with maybe 12 or 15 people and that meeting is not run very strictly on Robert's rules of order. So, you know, there's a lot of discussion, which is really perfectly appropriate. But at some point, you know, I would find myself kind of listening and then I'd say is so is this what you're trying to say? No, I'd take notes and I help people craft motions and they're like, yeah, yeah, that's, that's what I want to say. That's good. So it really helped me learn how to listen to a lot of conversations and try to distill the essence of what people were trying to accomplish.

Sue Griffin:                   05:55                And that has served me very well because part of the speaker's role is to serve on a committee called the reference committee, which is a group that helps people guide and craft their emotions in a way that's specific. And so it's really helpful for that, but it's helpful when you're trying to facilitate a group of 400. You have to be able to listen and kind of hear and try to sense where people are going. Cause they kind of know where they want to go. They don't always know how to get there. So I think that really helped. But then, you know, early on I became a member of the National Association of Parliamentarians, which has a lot of great educational resources. So that's how I learned a lot about, more about the intricacies of Robert's rules. And I was really lucky that I got to serve for seven years.

Sue Griffin:                   06:39                So I'm from Wisconsin, and Illinois runs a state assembly like New York does. So I served as their parliamentarian for several years. And so, you know, again, I wasn't running the meeting, but I had to understand it. I had to prepare it, it had to help me learn how to anticipate when amendments might be coming, how would you handle them. And so it really taught me a lot about how to prepare for the meeting in a way because you never want to be surprised if you can avoid it. So I would say those are really the main things that helped me prepare for the speaker role in particular.

Jenna Kantor:                07:15                I love that because there's not one way. What are other jobs, as obviously from what you got to be part of was helpful, What are other jobs that you would recommend people try to be appropriate for your position?

Sue Griffin:                   07:34                I think anytime you can be in a position where you are responsible for facilitating, so certainly, you know, being a chapter president, but even, you know, running a committee meeting. So, I think those are good roles. There's a position on the board of directors called the Vice Speaker of the house. So that person becomes obviously intimately involved.

Jenna Kantor:                08:00                So going back to that question, so what jobs, aside from the ones that you just mentioned, would you recommend people could take on in order to be appropriate for your position if they were looking and going, oh, one day I'll be Sue Griffin.

Sue Griffin:                   08:19                Well probably one thing I should've mentioned that I didn’t and it's you really need to be a delegate to the house of delegates, right? I mean, I did that for 15 years at least. So they need to be a delegate and that really helps them, I think link into other, I mean, at least to help me link into other opportunities, either at the chapter or section level so that they can kind of figure out their path. But again, being a secretary I think is a really good role. Anything where they have to run a meeting so they could be like even a SIG chair or a, you know, a committee chair. It doesn't have to be president, but certainly being chapter president could help because you obviously have to run meetings. Being on the reference committee is phenomenal. I mean it gives you a great role. And then we also have another position on the board called the Vice Speaker of the house of delegates. And sometimes people who've been in the vice speaker wanted to go to speaker and sometimes they haven't. So I mean it's not obligatory of course. And it's not required to be vice speaker, but those are some other ideas or options I would say.

Jenna Kantor:                09:20                Awesome. I love that. And what motivated you to work specifically towards this position? Cause there's a lot of positions that make a great difference in the APTA. So what made you go this is the fit for me.

Sue Griffin:                   09:33                Yeah, that's actually the only one I've ever really wanted. And you know, my very first probably hour as delegate, you know, back in 1995, I just was captivated by the formality of the proceedings. I was captivated by how he managed everything and how he really helped people accomplish their work. And that was very appealing to me to be able to help people move forward and accomplish what they wanted to do.

Jenna Kantor:                10:01                What is something you have accomplished in this position that makes you so proud? There may be many.  I can see your brain going tick, tick, tick. Oh Gosh, there's a lot. But I would love to hear one or maybe a few that pop in your head.

Sue Griffin:                   10:14                Well, it's funny cause you know, I'm a Midwesterner so I can't be proud of myself for anything. You know, I can be proud of other people.

Jenna Kantor:                10:21                That counts, that counts. We're all in this together, so I would love to hear that.

Sue Griffin:                   10:25                I mean I'm really proud of how the delegates work really hard. Well first of all I guess I’ve been really honored because they really have put a lot of trust in me and so they have allowed me to help them enact procedures and activities that make the house more efficient. And so I'm really proud of how people who've been really entrenched in something that's really formal and very traditional laden had been really willing to change and to take on change and to try different things and procedures to see if we can improve. I feel like the association on the whole is like on the cusp of really bold things and so I'm really proud of being able to help the house as a major decision making body try to also change in ways that are kind of in lock step with that boldness. I'm really proud of all the work the house created for the first time in my knowledge, a special committee to do a complete revision of every single policy position, standard document guideline in our whole association, like 350 documents and they've done this over the course of two years. So I'm really proud of their work and again, how they've really elevated the level of work and function of the house. So that's pretty cool.

Jenna Kantor:                11:40                That is. That is, and you've been around for all of it to happen. I love that. What goals are you working towards now or goal that you are working on in your position to just up the ante. Make it even better.

Sue Griffin:                   11:52                I think it's just kind of that same thing right? Like trying to continue to move on with that progression, stay in with the boldness, we're all moving into our next century, right. As a profession and as an association. So I think again, you know, people don't come together and meet in the same way that they did 50 years ago and the house is 75 years old this year. That's very exciting. It's got a solid feel. So you know, we don't do these things, obviously nobody works the way they worked even 10 years ago. And people I think think differently and want to interact differently than maybe they did 10 or 20 years ago.

Sue Griffin:                   12:38                So in order for the house to be meaningful and be a way for people to make decisions, it has to allow processes that are comfortable to people in that they facilitate the way they're used to working together.

Jenna Kantor:                                        Oh yeah, absolutely. Final question. Why do you love the APTA?

Sue Griffin:                                           Oh Man. Cause I said, you know, this is the best profession ever. And to be able to come together with a group of like minded, passionate, brilliant people, to be able to, you know, move our profession forward and to get people to access physical therapy who really need it. There's nothing better.

Jenna Kantor:                                        Yeah. I couldn't agree more. Thank you so much for coming on and just sharing your passion and also helping people understand not only what you do, but if they want to be the next Sue Griffin, how they could do it. So thank you. Thank you. Thank you.

Sue Griffin:                                           Well, thank you for having me on and everybody should go be a delegate.



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