LIVE from the Graham Sessions 2020 in Nashville, Tennessee, I welcome Erica Meloe on the show to discuss how to create a brand ambassador. Erica Meloe is a board certified physiotherapist in private practice in NYC. After a decade solving financial puzzles on Wall Street, Erica took her MBA and her problem-solving skills into the clinic. She specializes in treating patients with persistent unsolved pain and her mission is to raise awareness of the physical therapy profession to a level like no other.
In this episode, we discuss:
-The lack of public understanding of the role of a physical therapist
-How to turn your patient into your brand ambassador
-Inexpensive acts of kindness that will make you memorable
-Why you should network outside of your profession
-And so much more!
A big thank you to Net Health for sponsoring this episode!
Check out Optima’s Top Trends For Outpatient Therapy In 2020!
For more information on Erica:
Erica Meloe is a board certified physiotherapist in private practice in NYC. After a decade solving financial puzzles on Wall Street, Erica took her MBA and her problem-solving skills into the clinic. She specializes in treating patients with persistent unsolved pain and her mission is to raise awareness of the physical therapy profession to a level like no other.
Erica is co-host of the podcast "Tough To Treat: A physiotherapist's guide to managing those complex patients." She is also a thought leader in the profession and helps her patients, as well as her colleagues, empower themselves to lead and live with purpose.
Erica has also been featured in Forbes, BBC, Women's Day, Better Homes and Gardens, Muscle and Fitness Hers, and Health Magazine. She is also co-host of the Women In PT Summit, held annually in NYC. Erica is actively involved in spreading the word on social media and at her website www.ericameloe.com
Read the full transcript below:
Karen Litzy (00:01):
Hey everybody, welcome back to the podcast today. I am here with physical therapist, Erica Meloe and we are live in Nashville, Tennessee at the Graham sessions. And for those of you that don't know, Graham sessions is all about bringing up big bold ideas, things that might be controversial, things that may be we're not talking about as much in the profession and it's like a big think tank. And so today Erica and I are going to try and take that in, miniaturize it down to a podcast. So one of the things that really I guess gets to Erica is the lack of knowledge of what we as physical therapists do, how we operate and how we can help people. So Erica, what are some things that you have maybe even experienced? I'm sure this comes out of your experience as a practice owner and as a physical therapist for many years. So I'm just going to hand it over to you and let you kind of talk about some of the things that really get to you. And if you have any suggestions or solutions for other physical therapists or the general public that we can do to perhaps mitigate this situation.
Erica Meloe (01:14):
Well, thank you Karen. Thank you for having me on the podcast. Graham sessions is wonderful in Nashville. I've never been to Nashville, so I know it's quite nice. One of my mentors or business coaches asked me a while ago, what can't you shut up about and what I can't shut up about? I mean, there's many things, but this so irritates me is that people still, consumers and other healthcare professionals do not understand what we do at all. They don't understand. They think we're all exercise. And I know that this is a topic that's been beaten around for many, many years. And for me it's just, it drives me crazy. And I'll just tell you a story related to Karen. I had a patient of mine who just texted me. I'm an out of network practitioner and she has a certain like a deductible.
Erica Meloe (02:03):
She has to meet. She's like, well, I'm going to wait to see you. I'm going to wait to see. I'm going to go meet my deductible. I'm like, well, why don't you meet your deductible with me? Am I not as my profession? Not as valuable to you in your mind. And I think as a profession we need to start when we can talk about the marketing and the branding, but that's not what this is about. We need to start at the grassroots level with our patients. I mean our patients are our voices and we need to develop relationships with them and we need to actually make the ask. I think we sometimes in our profession, we're not shy, but we don't make the ask and I'm guilty of this. We don't make the ask of our patients.
Erica Meloe (02:50):
What is your view of me as a therapist? What is your view of me as a profession? How can I get a seat at the table? For example, you know in a discussion in Washington, how can I get a seat at the table? You know, at an AMA conference. I know a lot of physical therapists out there are speaking at other non PT conferences. But I think it first starts with our patients developing, we talked about you know, a lot of these business and leadership skills, these soft skills and yes, those are very important. But the relationship with our patients, the patients will get that word out. I mean there are time and time again, we both experienced it. You treat so-and-so and the word gets out. This physical therapist is different, this is what they do. And I think that starting with the interpersonal relationships, relationships matter, I think it was on Twitter, somebody mentioned recently that she spent 40 minutes on the phone talking to an insurance company or a doctor and was that worth her time? And you know, she got a lot of comments and it was like relationships matter and that's value to the patient.
Karen Litzy (04:02):
Oh, absolutely. So I agree with you. It's all about relationships and those relationships, that Alliance that you create with your patient, that patient then goes out and they become your ambassador and not only an ambassador for you, but an ambassador for the profession as a whole. So instead of saying, which we heard today, people say, I went to PT and it was crap and they didn't do anything. But instead, wouldn't it be great if all of us PTs are forming these relationships, are treating patients with the latest evidence, are not wasting people's time, are making people feel better. Or I would even argue making people more functional, getting people to an elite level of sport. And that's what physical therapists can do. And I feel like a lot of patients, if they have gone to a physical therapist and they say, I did, they just put a hot pack on me and then some Estim, then do my exercises. And then I left. And you know who that patient was? My own dad. My own dad was like, well, why would I do that? He's like, I can put a hot pack on at home and go to the gym. Well that's not quite the care that your talking about.
Erica Meloe (05:21):
Right. So that was your dad. So you know, he would never say anything to you like you know he would not basically say, you know, all physical therapists are like that because you're his daughter. So you know, I talk about, you know, building relationship with your patient and your patients. Number one are your advertising or your marketing and your brand. You know, we can spend a lot of money and we, you know, a lot of people do on all of these business courses and that, you know, marketing and the branding and the social media and that's all great. But if you don't have a relationship with your patient, it doesn't matter.
Karen Litzy (05:58):
What are some tips that you can give to the listeners to create a good relationship with your patient.
Erica Meloe (06:03):
But say, you know, and I speak from experience and seeing other therapists work over my years, go the extra mile for your patient. Go. There are many times in patients, for example, they're going, they'll email me, they'll text me and on weekends and I answer those text messages and I answer those emails and they are like, thank you so much for answering an email on a weekend. And yes, that's a very basic example, but actually matters to these people.
Karen Litzy (06:37):
Well, the basics matter. That's the simple little things that you can do that takes two seconds of your time.
Erica Meloe (06:45):
And also just listening to your patients. And yes, I do have a tendency to run a bit late when I see patients, but I will tell you, Karen's laughing cause you know, but if someone asks you a question and you're 10 minutes late for your next patient, you don't just say, I can't answer it now. You know, and this is obvious, but that patient, they may have gotten a hundred percent better with you, but they're, Oh, they're going to remember it. That last encounter. You need to make every encounter matter, whether it's listening to the patient, whether it's you know, listening to them about something that's unrelated to physical therapy. And going that extra mile. And asking the patient, you know, what do you want from this relationship? It's a relationship and it's a trusting relationship. And, once again, you know all the branding is fabulous, but they're your voice.
Karen Litzy (07:49):
Yeah, absolutely. And I think it's also important to remember that this isn't a relationship of you being above your patient. It's a partnership relationship.
Erica Meloe (08:07):
And what do partnerships do? You know, they give and they take and there's a sacrifice, but I would offer this advice is your patient is your patient for life. Right? It's like that lifespan practitioner that we talked about so often and they should be treated as such. For example, when they leave your office for, let's say you've seen them for 10 visits, their back pain's gone and they're kind of good to go, but they're not really, once again, we don't discharge patients, you just, you know, see them and then they come back whenever they've got something else going on. It's not a word I like to use that. It's funny, I often say I don't use discharge anymore. I actually say you know, I'll see you if you have any other problems, just just come on back and I will keep in touch. I actually think using direct mail, and I've tried this, said this before really helps.
Erica Meloe (08:52):
I actually send birthday cards out and thank you cards and thank you cards after I have a a new patient, I will send a thank you card. Thank you so much. Nice meeting you. And patients are saying they come back and they're like, that was a great touch. I really appreciated your card. Honestly go into your database. I’d get an Excel spreadsheet of all your birthdays of all their patients birthdays. It is an easy thing to do and then just note them down and write them, go on a Sunday, spend an hour and a half doing that. It will matter. I know, it's funny because I had an assistant of mine do that and I was like, Oh, she has a birthday very similar to mine and you know, and, and they actually do appreciate that.
Erica Meloe (09:37):
And you know, I've been a patient myself and I, you know, we hope we can get the odd email and everybody's about, you know, the email marketing. Yes. However, it's not the same.
No, it's definitely not the same. And, and I also can appreciate those tips that you just gave, listening to the patient, sending a birthday card, a thank you card and helping them kind of understand what we do and taking the time for them. These are not huge things. You don't need a certification for it. You don't have to spend money for it unless you get a stamp or something. It's very easy, accessible ways for everyone to enhance that relationship.
Erica Meloe (10:33):
Right. I think someone mentioned today that you might not be the best therapist in the world, but if you've developed a relationship with your patient, that's golden. And I received something from one of my coaches recently and it was a card and it said the best is yet to come. And I was like, Whoa. I was so touched by that. And it took her what, maybe five minutes to write that and not even, and that, and I remember that. I remember that. And when someone is sending that to you before you have to renew a coaching program or before you have to do something, I'm going to renew. I'm going, of course I'm going to renew because that was a great touch. You know, that's the customer service that people forget that we actually need to do in our field.
Well, it makes you feel quite simply that you matter. Yes. And isn't it great that we as physical therapists can give to our patients the gift that they matter because they might not be getting that elsewhere. So if you can do that for your patient, they're your brand ambassador for life.
Erica Meloe (11:20):
Absolutely. You know, and when I started early on, you know, as a business owner, I was actually afraid to ask my patients for referrals. You know, I really was. And to this day it still is hard, but it comes out a bit easier now, you know, if you know of anybody else that could need my services, I really enjoy treating the difficult patients. Just, you know, send them my way and it comes out easier that way and we all have a different view, but they fade like you, you will do that.
Karen Litzy (11:54):
And I remember thinking to myself, Oh, I don't want to do that. It sounds so slimy. Like used car salesman. I don't want to do that. I don't want to be that person. And I remember somebody saying to me, but you're not slimy. So it would never come out that way. So if you're not slimy and gross and you ask someone, Hey, listen, I love doing this. If you know someone, definitely send them my way. I'm accepting new patients anytime. Like it's only slimy I think if you're a slime ball.
Erica Meloe (12:17):
Exactly. And it comes out very you know, with integrity, right? And it's not, of course not because, and if you say it with the passion, like you just did, you know, I love to treat these patients. I love to treat patients just like you. How special is that, right? That you make them feel special and they'll be like, Oh, of course, you know, it's like asking for reviews on a podcast. Oh, I didn't know I had to write a review. You know, can you write me a review? Boom. They don't understand it. And I think that is a good relationship. And once they realize that you'll be in the top of their brain and then they're going to be like, well, that experience was very valuable to me. You know, the birthday cards, the, just developing the rapport, rapport and just establishing relationships that, where it's a, you know, a given a take, but it's almost like a marriage in a way. I mean I'm not married and I certainly know I'm experiencing that, but when you have business partners or podcast partners, it's a given a take. And the ones that last the longest are the ones that, that work together. They collaborate. That's the best recipe for success.
Karen Litzy (13:24):
Right? And exactly what Erica just described is how we as physical therapists can help the general public know what we do, right? So it goes back to the thing that gets Erica every time is people don't know what we do, but there are what 300,000 physical therapists in the United States? It's a lot of people. And so if we can make a difference with every person, then can that cause a little ripple that can become a wave.
Erica Meloe (13:50):
Right. And I would also urge patient physical therapist to go to conferences that are not physical therapy related. Go to a leadership conference, go to a medical writing conference. Go to an urology conference or a women's health conference or that's the wheel. You'll develop relationships and you'll be the brand ambassador cause you'll be the only physical therapist there.
Karen Litzy (14:23):
Very true. Right. Great advice. Well what are the big things that you want the listeners to take away from this?
Erica Meloe (14:29):
That it's the small things that really matter. It's kindness. That's my word of the year by the way. I remember had the word of the year, that's my word of the year. Kindness. It's the little things that matter. Sometimes we need to go back to business 101 like direct mail that actually does work. You know, it really does. That's the main thing. And don't be afraid to collaborate with nonphysical therapist acupuncture as they're developing a relationship there. Cause you will educate them, you really will. And you have to be passionate about this. If you don't, if you're not as passionate about it as I am, you'll do it like half assed in a way. And you know, so, but start with your patients and pick a few patients you really like and you, you know, send birthday cards, send thank you cards, do it for one or two months and see if you get any return on your $1 investment. It's nothing.
Karen Litzy (15:27):
Great advice. And now what advice would you give to yourself knowing where you are now in your life and in your career? What advice would you give to you as a new grad right out of PT school?
Erica Meloe (15:40):
Stop overthinking. I analyze, overanalyze everything and that's good and bad. And I think that if I were coming out of PT school right now, it's not the latest and greatest social media course or marketing course or branding course. You could easily do those via YouTube. I mean, and obviously, you know, but it's really about what are your strengths? We talked about this at the women in PT summit. You need to play to your strengths. Like I like to problem solve. That's one of my strengths and so I would suggest anybody coming out of PT school, do a deep dive into what your strengths are, there's many StrengthFinders is a great one. I would really do a deep dive into looking at what your strengths are and play off of those. Get really good at those and you will find ways to apply those in physical therapy.
Karen Litzy (16:36):
Fabulous. And where can people find you?
Erica Meloe (16:38):
Oh gosh. Online. We've got an Ericameloe.com my velocityphysiony.com and I'm in New York city right across from Bloomingdale's and all my Facebook, Twitter, Ericameloe. My podcast with my wonderful cohost, Susan Clinton. Tough to treat. And my book, Why do I hurt? Discover the surprising connections that caused physical pain and what to do about them. That's on Amazon, Barnes and noble
Karen Litzy (16:50):
Awesome. And just so everyone knows, we will have links to all of Erica's information under this episode at podcast.healthywealthysmart.com so Erica, thank you so much. Thanks so much for listening and have a great couple of days and stay healthy, wealthy, and smart.
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On this episode of the Healthy, Wealthy and Smart Podcast, Jenna Kantor guests hosts and interviews Keaton Ray and Scott McAfee on how to develop a successful business partnership. Keaton and Scott are MovementX business partners. MovementX is on a mission to heal the world through movement. We believe that if you can move your best, you can live your best. We are doctor-founded and patient-focused to help bring more convenient, transparent, and personalized physical therapy care to the world.
In this episode, we discuss:
-What is MovementX and how is it revolutionizing physical therapy practice?
-The importance of identifying the strengths and weaknesses of your team
-Why you need different channels of communication in a partnership
-The key elements of a successful business partnership
-And so much more!
A big thank you to Net Health for sponsoring this episode!
Check out Optima’s Top Trends For Outpatient Therapy In 2020!
For more information on Keaton:
I am a passionate physical therapist and wellness/fitness specialist in Portland, OR specializing in reducing pain, increasing strength, restoring mobility and balance, and optimizing performance. I've worked with clients across the lifespan from those who have never exercised a day in their lives, to those who are afraid to exercise because of pain, to advanced athletes looking to take their performance to the next level.
For more information on Scott:
Dr. Scott believes in a world where anyone can move & live their best. The problem is that with today's healthcare system, finding the best care, avoiding crowded clinics, and dealing with insurance can be frustrating. That's why he chose to do things differently. Dr. Scott's practice is 100% mobile–he provides care in the comfort of your home, gym, or office. He brings a mobile treatment table and helps you decrease pain, increase strength/mobility, prevent injury, restore function, and coordinate your care plan. Wherever & whenever you need care, he can be there. It's convenient, valuable, & personalized to whatever you need. Dr. Scott works with a wide range of people, from youth athletes & avid runners to active grandparents & busy businesspeople. Call or text the number above to get directly in touch with him, and you can have a free phone consultation about what health goals you want to accomplish!
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 (www.jennakantor.com) 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: www.jennafkantor.wixsite.com/jkpt
Read the full transcript below:
Jenna Kantor (00:00):
Hello, this is Jenna Kantor here with Healthy, Wealthy and Smart. I'm here with Scott McAfee and Keaton Ray and I am tired. We are at Graham sessions 2020 and I am so lucky to be interviewing the two of you on your partnership with movement X. So first of all, thank you so much for coming on. It's an honor to be speaking with both of you. So first, would you mind explaining what movement X is and then dive into how your partnership began?
Sure. So movement X is a group of United providers across the country who are providing care in an inspired way. So we refer to it as the 11 star experience. We're going above and beyond the five star experience and providing care where people need it most, when people need it most, whether that's at their home, at their gym, at their workplace, on the track and field at their doctor's office. We're showing up and providing care that makes a difference. So improving lives on both sides of the treatment table for the provider and for the patient.
Jenna Kantor (00:58):
All right, and now your partnership.
Sure. So where to begin? So Scott and I first connected on movement X in 2016 or early 2017. Started with a phone call. I knew that Josh D’Angelo and myself couldn't do this on our own, so we called up some trusted partners that we had known closely through the APTA. Scott was one of the very first people we talked to and immediately had a connection over the mission, which is you know, help people move their best so they can live their best. And I'll hand it over to Scott who can explain the transition from that first talk about movement X to him, actually quitting his job, moving across the country, dropping everything to help us with our vision.
Scott McAfee (01:50):
So it was a very exciting time for me. I was just finishing up my residency program in Southern California. And I loved the people that I was working with. I loved my coworkers. I love my patients. And it was really an amazing residency experience at this hospital. However, I was somewhat displeased with the with the environment of dealing with insurance companies and being somewhat limited in my ability to truly and deeply care for people that I knew I had the potential to as a physical therapist. And after my conversation with Keaton, I got really, really inspired of what the opportunity looked like for physical therapists in this more mobile cash pay model. And it was I think about a week after I had passed my residency when I knew, wow, there's some real opportunity here.
Scott McAfee (02:52):
And Josh D’Angelo one of the cofounders along with Keaton he had been in the Washington DC area for seven years, was very well connected out there. And at the time right when I was finishing up my residency, I was very comfortable down in Southern California. I had a very strong network. My life was just going straight according to plan per se. And I've never quite learned at any point in my life from a point of comfort and I wanted to flip that on its head. So I decided to move all the way to the East coast to join forces with Josh D’Angelo in Washington DC in addition with Fred Gilbert who moved from Alabama to Washington DC and that's how the partnership began and we began expanding from there and it's just been an absolute wild ride since
Jenna Kantor (03:49):
I love it. And I love how you two interact with each other. You're both good friends as well as definitely business partners. How the heck did you get to that point? Cause I would love for you to first go into your struggles and then what you did to implement something that would work between the two of you.
Keaton Ray (04:08):
That is a good question. So all of us, everyone who started the company actually started as friends way before we ever started at business partners. And that is both one of our deepest strengths as well as probably one of our greatest challenges as well. But from day one, it was intentional on our part to learn each other's strengths and be open to each other's weaknesses and communicate if not over communicate about each one of those. So there is times when Scott and I probably are just at each other's necks, including other people. I get frustrated on a daily basis with everyone and they get frustrated with me. And that is okay, that is normal. But what we've done is we've gone through intentional work where we set aside hours at a time, both on the phone and in person to be open about those strengths and be open about those weaknesses. And each and every one of us over the past two, three years has just grown because of that intention that we've put into growing each other. So it is not easy. It definitely changes the relationship, but it's worth the intention.
Scott McAfee (05:12):
And Keaton and I, we both go back to the student assembly board of directors, although we never served together. I learned so much about how I function on a team in that environment. And I would imagine that you learned the same. And I think once you truly understand yourself and then also once you truly understand and appreciate and realize the mission of what your team is trying to accomplish, that how you get to the end goal of accomplishing that task is irrelevant. You just have to get there. And yes, you are going to agree on certain things you're going to disagree on probably even more things if your team is actually functional. But at the end of the day, as long as you are on a team, it can get to the end goal. That's what matters most. And from there you walk out of the room, no matter what discussion happened inside of that room, all with the same mindset of, Hey, this is our goal. We may have disagreed on how we got here, but now we're all in agreements. Hey this is what matters most. And, you have a clear sight of where you're going.
Keaton Ray (06:27):
One thing I'll add to that, the other two areas of strength. You said it perfectly, Scott. I think one is putting infrastructure into being able to build a communication pathway. So we have a lot of various company languages that we use that help us recognize when we're falling into several habits that may affect the growth. So one example is the six thinking hats. So six thinking hats. You know, the red hat is the emotional hat, the white hat is the fact hat. The green hat is the innovation hat. The yellow hat is the optimism hat. The black hat is the devil's advocate hat. Josh D'Angelo would be so proud. I just remembered that. And so sometimes when we're in a heated conversation or we don't see things eye to eye, we need to recognize, Hey, I'm wearing my red hat right now and you're wearing your white hat. No wonder we're not seeing each other. And various communication pathways like this have helped us to recognize where we're falling short and where we need to improve. And so without those types of things, it would be a lot harder to grow as a team.
Scott McAfee (07:25):
I love how you brought that up as an example because not only does that help us make decisions in the board room per se with business it's also helped me make personal decisions, look at problems that I'm facing in my own life from many different angles, right? Hey, if I had a green hat optimist view of this versus a devil's advocate, why would I talk myself out of this? I think I've been able to look at things from somewhat of a stoic and very objective point of view rather than getting to red hat emotional about certain things. And it's also helped in personal relationships as well. So as much as you can grow together in the boardroom, I think you take away so many different things on a personal aspect as well. And yeah, I love that analogy. That was something that Josh D’Angelo initially introduced and has just been so helpful.
Keaton Ray (08:19):
One more. The last thing I'll say too is if you ever want an ego check, join a group of six. We started with six incredibly innovative, intelligent, outspoken leaders. Sit yourself in a group of six outspoken leaders and have them debate your mission and your vision and your processes and everything in the background there. There is no space for ego when you are working with this large and this capable of a team. So you cannot be a solopreneur and accomplish what we're trying to accomplish. So we've all really worked hard in our egos and it's not always easy, but every single person on this team has done a great job.
Would you mind sharing your own personal things you've learned about exploring how you work? I think that'd be interesting for people to hear. You're like, I am actually a person who's like this, I would love for you to share that. So then people could even learn how you are so different.
Scott McAfee (09:16):
So I might take a second to think about that. And that's something that I have learned about myself is that it often times helps me to take a second and think of getting my thoughts together on how to approach a certain question or an issue or how to solve a problem. Rather than to just speak my mind immediately. But I will say that right off the bat that going into this team, I'm in just awe of everybody who I get to work with on a daily basis. And people often ask me, Hey, why did you move to Washington DC? It wasn't only for this like larger mission and this larger purpose. It was to have conversations late at night with people who inspired me who I just looked up to in so many different ways. And that was a goal of mine when I was actually looking for different colleges to apply to. I was like, who could I surround myself with and have just really deep and insightful talks late at night with and I just feel so fortunate to be able to do that as part of this team and as our youngest member on the exact team that we have, I oftentimes do try to just be a sponge and take in as much information and inspiration from my team as possible.
Keaton Ray (10:41):
I was laughing through Scott's excellent explanation because sometimes I think we can explain each other's work habits at this point better than we can explain our own. And so I am the opposite of Scott, although it's gotten, I have the team probably operate the most similarly. But you know, there's differences between everyone. So I am very blend and I should take more time to stop and think first. But if something's on my head, it is right out in the open. And so one of the things that we've really worked on as a team between Scott and I, but also between all the team members is managing conflict. So some of us on the team are much more comfortable with conflict. Me being one of them, while others have a little bit more of a reservation around conflict. Now compared to other people, everyone is excellent at managing conflict, but it's a personal comfort as to how you actually deal with that.
Keaton Ray (11:31):
So I would say while Scott says he's much more, you know, maybe has to think about it in, in the background a little bit. I am much more of that writing your face. Oh, I don't agree with that. Or Oh, I totally love that. You know, kind of person. So a lot more forward facing. But what Scott and I have as an extreme similarity is that we are the doers. We're like, let's do it tomorrow. We have idea. Great. Okay, I'm going to stay up all night. We're going to crank this out. We're going to have a product tomorrow. We're going to launch it, we're going to test it a little bit and we're going to redo it. Whereas Fred and Josh tend to be much more of those visionary. Like, let's stop. Let's look longterm. Let's think of how this affects this. And, it is a wonderful combination because all of us compliment each other so well. You can't have one leadership style without the compliment of the other, but it can lead to frustration. You're moving too fast, you're not moving fast enough. You know, back and forth. So the communication puts us all in alignment and we're stronger because of it.
Scott McAfee (12:30):
Yeah. Actually one of the core values in our company is passion times purpose. And you can't have one without the other. And the way that I think about that is you cannot have action without strategy as well. And that's one thing that Josh and Fred are so instrumental in teaching us and teaching me and even keep me, is inspired me in so many different ways to behind everything that I do. Always have a strategy and don't skip steps in the action that you want to take. So I think that's very important.
Jenna Kantor (13:03):
I love that. I love that very much. What made you decide to hire out to figure out how to work better together? How did that, I'm sure alone cause you hadn't figured it had something in play like you do now. How did you get to that agreeing point to go, okay this is who we're going to invest in to improve our communication, to improve our partnership? How'd you get there?
Yeah. So I think what you're referring to is the consulting work that we did for a team development. So we actually got incredibly lucky. We got chosen by a graduate program working on human resources and team development as their trial team to take a deep dive look into each one of our personalities and our work habits and then do basically a report. So we each had a one-on-one like hour long talk with this consulting firm and they went deep into our work styles.
Keaton Ray (13:53):
We'll look it up, we'll look it up. And so then they came back at us and basically gave us a very honest report about how our team is functioning and then gave us assignments on how to dive deep and improve the report essentially. So it was a really hard activity and emotionally draining, but it was so bonding and we're so much stronger because of that consulting work we did. You have to recognize your weaknesses. We knew we're not perfect, nobody's perfect. And so we're willing to invest in the team to improve because without this team, the mission of this company doesn't go anywhere.
Scott McAfee (14:33):
So it was a graduate program at Georgetown university.
Jenna Kantor (14:42):
Yeah, that's very cool. I love that you guys said that is still looking it up to see if she could get more information. And I want to find this information for the listeners in case there is somebody starting a business who might want to look this up and see if this program might help them as well. Because seeing how you two interact, like I said, there really is some magic, dare I say Disney magic happening between the partnership and I think that is absolutely spectacular. Did you find the name?
So it was Georgetown's graduate program. Robin Goodstein graduated from that program and started her consulting firm called Balcony consulting. So anyone looking for team-based collaboration and consulting, she's incredible.
Now what are your biggest challenges that you have and the easiest things for you guys overall? Cause you guys have grown together, but what are just the constant things that you expect to be like, okay this is a little challenging and this is like easy.
Keaton Ray (15:58):
So this is a hard question. That's a great question. But I think that the easiest thing that we have now is a baseline understanding of how each other operate. The first few months in definitely year plus was just learning each other's habits, learning each other's needs and learning each other's emotions. And now I think we have such an intricate understanding of how we each operate that it's much easier to move the company with speed. Knowing that, I think the hard part is, is we're now in a place with the company that we're really truly starting to grow and we're going to run into barriers that are unlike anything we've ever had. And so, so far we've been able as a team to come together and hustle and make this thing work and create an amazing movement. But we're going to max out of our own knowledge. And so we're going to have to find new team members who come into our company who do not have the same intricate knowledge of one another. So now it's not just managing each other, it's managing other people and having them fit into the culture as strongly as we do.
Scott McAfee (17:00):
I think that's perfectly said because we agreed too much. No. because it's going to be so special and like I said, such a wild ride ahead as we do grow and with as many things that are going to change and as many new obstacles that we're going to face, I truly do believe that we do have a very strong foundation and like you said, baseline understanding and respect for each other and how we both operate. And that goes for everybody in our team and in our community. The more that we can better understand how we operate and all speak the same language they all have the same core beliefs and core values and share so much of the same culture. If you know from a deep level that binds you together, I definitely believe that no matter what obstacle may come your way, you can adapt your team in a very nimble way, in a very strategic way, in order to accomplish that. We're with as many problems as we face and with as much as we have accomplished you know, the sky's the limit. And, I think there's so much growth waiting to be had that it's just so important to have that foundation before you have anything else.
Jenna Kantor (18:21):
I love it. Thank you so much. You too, for coming on here at this crazy, magnificent time here at Graham sessions, you two really set a great bar that is possible for anybody to achieve at their business partnerships. So thank you.
Scott McAfee (18:36):
Appreciate those words, Jenna and I couldn't echo the same thing about you and Karen. You guys are great. This podcast has inspired me when I was a student. So I just feel very fortunate to have the opportunity to speak to your audience and hope that we've spread something valuable worth listening to. So I appreciate you
Keaton Ray (18:58):
Agreed all around. Thank you so much for this opportunity. The one thing I'll leave the listeners with is if you want to build a team and you want to grow a mission, you have to be vulnerable. You have to put yourself out there and let people see what you do know, what you don't know, your hesitations, your fears and your vulnerabilities. Because without that, there's no way you can connect with people enough to build something as meaningful as we're trying to do. So be vulnerable. Put yourself out there, let go of your ego and you're going to create an amazing company culture.
Jenna Kantor (19:37):
Thank you so much. I was wondering where can people find you online if they want to try to reach out to you?
Scott McAfee (19:44):
So we are on Instagram @movementXinc and we are a online also www.movement-x.com.
Keaton Ray (19:55):
Note, our company name is movement X. No space, no dash, but our website is movement-x.com.
Wonderful. Thank you so much. So thank you listeners for chiming in to this great discussion. This will also be in the bio as well. If you want to just check that out too, if you're having a hard time remembering what was just said on how to reach out to these fantastic individuals. Thank you so much.
You can also reach us at email@example.com. We want to hear from you. We're always willing to hop on a phone call.
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!
LIVE on the Healthy, Wealthy and Smart Podcast Facebook page, I welcome Chris Napier on the show to discuss the science of running. Chris Napier is a Sport Physiotherapist with a PhD in running biomechanics and injury prevention. He has an appointment as Clinical Assistant Professor in the Department of Physical Therapy at the University of British Columbia.
In this episode, we discuss:
-How to bring a wearable to market for running retraining and injury risk reduction
-What to look for when investing in wearable technology
-The importance of translating the research to both the clinician and athlete
-Science of Running: Analyze your Technique, Prevent Injury, Revolutionize your Training
-And so much more!
A big thank you to Net Health for sponsoring this episode!
Check out Optima’s Top Trends For Outpatient Therapy In 2020!
For more information on Chris:
Chris Napier is a Sport Physiotherapist with a PhD in running biomechanics and injury prevention. He has an appointment as Clinical Assistant Professor in the Department of Physical Therapy at the University of British Columbia. In addition to working on research projects, Chris continues to be a practicing physiotherapist with Restore Physiotherapy and Athletics Canada. He has competed at the national level as a successful middle-distance runner, earning medals at the Canadian Track & Field Championships in 1996 and 1997. He is also an accomplished marathon runner with a personal best time of 2 hours, 33 mins.
Read the full transcript below:
Karen Litzy: 00:01 So welcome everyone. So for those of you who are watching live, thank you so much for taking the time out of your day and coming on to watch and learn. Oh good. I'm just making sure that it works. So I just had to check on my iPad to make sure we're live and we are. So thanks so much for taking the time out. As we go along. I may ask you just to kind of write in the comment section where you're listening from. If you have any questions, by all means, definitely, definitely ask. Now is your chance, I'm sitting here with Dr Chris Napier. He is an expert. He is a new author. We'll be talking about his book, the science of running in just a little bit, but Chris, just to kind of allow people to get to know you a little bit more. Why don't you kind of give the listeners and the viewers here a little bit more about you.
Chris Napier: 01:05 Sure. well thanks again for having me on Karen. I feel like I've really made it big time. Now. I'm on the Karen Litzy podcast. It's huge. So thanks again for having me on. So I'm a sport physiotherapist. I've been practicing for almost 20 years now. And, I've worked with a range of sports. But I sort of ended up coming back to the sport I'm most passionate about. The one I love which is running. About 10 years ago I started really focusing more on running and it was basically because I'm a runner myself. Out in the community running with the various sort of recreational races training with different clubs and so then and talking to people who are running all the time. So it really sort of just made sense for me to kind of work a bit more clinically in that field.
Chris Napier: 02:00 And at the same time I was getting interested in pursuing more research. And so I started my PhD in about 2012, 2013. And I focused on running and I was really interested in being able to quantify aspects of running in terms of running form and biomechanics. So my PhD was on running biomechanics and sort of clinical interventions using gait retraining to prevent injury. And so I finished that in 2018 and I've moved now more out of the lab so to speak out of the biomechanics lab but still interested very much in the mechanics of how we run. And I'm now working with a group of engineers at Simon Fraser university doing my postdoctoral fellowship there where they actually develop a wearable. And so we're doing some really cool stuff there in terms of actually developing potentially products that will be available to clinicians and to runners to measure their gait.
Karen Litzy: 03:13 Very cool. And I will also add that you are sort of at the helm of the third annual world conference of sport physiotherapy in Vancouver this year. It was an amazing event. You and the team you guys did such an amazing job and I'm sure that's the feedback that you've have probably got from the conference, from the people who attended. So I just wanted to give you guys some more accolades and a nice shout out cause it was a really, really well run conference with some great info.
Chris Napier: 03:48 Yeah, that is the feedback we've had, which was fantastic to hear from across the board. And, I'm really looking forward to our continued support for your therapy candidate conferences, which will be a biannual event and as well the next world Congress, which will be excellent, I'm sure as it's being hosted in Denmark.
Karen Litzy: 04:08 Yeah. Yeah. That'll be fun. And that's in 2021. So that'll be a good time. And again, if you're watching live, I know I saw a couple of viewers watching live at the end of this, hopefully we're going to give away Chris's book. It doesn't come out until February 4th, but if you write your name or a comment or where you're watching from in the comment section, you're automatically in the running for a free copy of the science of running by Chris Napier, which is very exciting. So Chris, let's talk about wearables. So when I think of wearables, to me it makes me think of like a Fitbit or maybe an Apple watch or something like that. So in your introduction, you'd said that you're working with a lab as a postdoc. So when you say wearables, is that what you mean or are you talking about something else?
Chris Napier: 05:11 Yeah, so I mean a wearable is really a broad category. And you know, for anyone who follows the consumer electronics show, which was just recently in Las Vegas you know, I think that area is huge right now across the board. And, we think of it very much in the health lens. But really a wearable, wearables, anything you can wear on your body that tracks something whether it's, you know, your heart rate or your breathing rate or your pulse or your blood pressure or skin temperature or joint angles, impact forces. I mean, it goes on and on. Really anything we can measure through something we can wear. So, you know, by nature it's something that's portable often, you know, connect with some sort of app either on a Bluetooth device or we'll sort of record onto the actual hardware itself or download later.
Chris Napier: 06:15 But you know, that's the other side of it is, you know, beyond the wearable, the actual interpretation of the data and the visualization of that and that sort of thing. That's a whole other field as well. But the lab I'm in is looking at wearables that can measure health-related metrics. And so some of the projects we have going on there are looking at recovery from stroke or looking at you know, more fine motor function, that sort of thing. And my area specifically is looking at an application to running.
Karen Litzy: 06:53 And so when, you know, I think about application to running and you think about, you know, perhaps using a wearable to enhance someone's running, whether it be their running gait, their endurance, their times. And what I think of right off the bat is a running analysis where you've got someone on a treadmill and you've got multiple cameras and they've got dots all over them and all their joints, which is not something that every clinic has the ability to do because those setups can be quite expensive. So what are you doing within your research that might be a little different and offer clinicians something that might be more practical?
Chris Napier: 07:40 Yeah, so what you described there that sort of motion capture 3d motion capture analysis which is sometimes done on an instrument, a treadmill, which will give you force information as well as the joint position movements. But that was my PhD. So that's what I did. I looked at basically a snapshot of people running and then assume that that's how they ran when they left the lab. Which is a big assumption, right? And so what we're doing is we're trying to get those same measurements but in something that can be worn outside of the lab and in the natural environment which gives us it opens a whole other world to what we can measure. We can measure things where, you know, rather than on a treadmill, which might be unnatural for a lot of people, we can measure them running on the road or through trails or uphill or downhill.
Chris Napier: 08:40 We can measure how their mechanics changed throughout the course of a run. You know, so we can see what happened when they start to get fatigued. We can measure in a race situation you know, when people perhaps run differently cause they're pushing themselves to their limits. And we can also measure over time, over a weeks or training blocks so we can see what happens to people's mechanics. As a more chronic sort of fatigue sets in. So there's a lot of stuff that we can study. And, in our lab we have sort of the ability to embed some of these wearables into garments. And so essentially we're developing smart garments. And we published a recent paper looking at using a set of running plates to measure hip, knee and ankle kinematics during running. And, we developed this and I think it compared to the gold standard, which is still the three D motion capture and these tights do very well at measuring that movement. Which is exciting cause then, you know, we can start to produce these and runners can start collecting data wherever they run.
Karen Litzy: 10:01 Yeah. Which obviously seems a little bit more practical than, like you said, just being on a treadmill. We know running on a treadmill is definitely different than running on the road or the track or real life situations. And is that something that a, let's say your average physical therapist practicing PT like myself, if someone comes to me with a running related injury and I mean, I don't have access to a three D running analysis, is this something that I would be able to say to this potential patient he lives in? I have some wearable technology that you can use that might give us a better picture as to what's happening when you're running.
Chris Napier: 10:49 Yeah, I mean, we're not there yet, but that's certainly where we're going. So, you know, I guess potentially we could, we could put this pair of tights on a runner and we could track their hip, knee and ankle kinematics while they run either on the treadmill in the clinic or we could send them outside and have them go for a run and come back. And or you know, these could be something that the clinic can loan out or rent out and maybe patients keep them for a week so we can track their running mechanics over the course of a week. And then that could potentially be uploaded to a cloud or brought back to the clinic and downloaded so that you can look at their data over time. And what we're using our strain sensors to be able to measure kinematics.
Karen Litzy: 11:38 And what does that mean? What's a strain sensor?
Chris Napier: 11:40 Well, essentially these are thread like sensors that the amount of strain produced can give us an idea of how much movement is occurring.
Karen Litzy: 11:52 That's sort sewn into the fabric.
Chris Napier: 11:54 Exactly. And we've done, you know, a lot of the research we do is looking at where we need to place these and how many sensors we need and that sort of thing. And so that was the big work sorta involved in developing these tights is to figure out how many, you know, can we get away with just having three or four sensors which reduces the you know, the cost of energy and also the amount of processing involved and where can we put those to optimize you know, the metrics we're looking at. But you can also then add inertial measurement units or I am use which have accelerometers and gyroscopes in them, which can then add a whole other layer so we can look at you know, impact. We can look at angular philosophy and things like that. So, you know, we're looking at integrating those things right now as well.
Karen Litzy: 12:53 And all of that can be so knit fabric of a pair of tights.
Chris Napier: 12:57 Yeah, yeah. We're talking about pretty small.
Karen Litzy: 13:01 That's wild. And so, you know, you did a study kind of taking these tights and looking at, well, how many sensors do we need and where do they need to be placed? And was this sort of a preliminary study, cause I can understand the need for knowing how many sensors you need and where to place them and then kind of recruiting a larger amount of runners to kind of study to see does this do what it says it's going to do it in a nutshell. So right now, just so that the viewer isn't, so that I myself get a better idea. So right now you're sort of in that developmental stage where you're looking at where to place them and how many, and do they work?
Chris Napier: 13:48 Yeah, we've done that. So basically this study was that, so we were happy with where they are and the number for what we want to measure. And so now what we're doing is can we use these to give us information about you know, the fatigue state that runners are in. So, you know, when we're getting into machine learning and that sort of thing as well with this. So you know, can we classify a runner as being fatigued or not? For instance, based on the information we're getting from these tights or, you know, and then as I said before, like, can we get these out now and actually get people using them so we can start collecting large data sets. You know, that's where it gets interesting. Can we get these out to hundreds and thousands of people to be able to start collecting data on those numbers and really start to refine the technology and perhaps see some interesting patterns.
Chris Napier: 14:49 And you know, there's some of the studies coming out of refurbish lab in Calgary have been doing that. They use the now defunct Lumo device, which I am used situated on the waste. And they've done some really interesting work with Christine Claremont leading that and Learn Benson looking at sort of classifying situations or types of runners based on the data they've gotten from those devices. So we'd be looking at maybe doing some similar work with ours.
Karen Litzy: 15:30 Yeah, I mean, very cool. And, I guess the next question is why should we care? So as physical therapists or even as runners, like, yes, this technology is cool, it has the potential to give us a lot of data and a lot of information, but why do we care about that?
Chris Napier: 15:54 Yeah, exactly. So, you know, I think first of all, we have to figure out, is this going to give us information? That is I think we can be happy that it would be reliable, but really we're looking at the validity. Are we getting information where we're going to see patterns that lead to injury. And that's again, that's kind of where we're going with this. But at this point we can't say that that's where we need those large numbers. And hopefully I think that's what we will find is that we can kind of see trends. I mean, there may be a time where, you know, these are sold in running stores and people just wear them and then, you know, they get injured and they come in and say, Hey, yeah, here's my data.
Chris Napier: 16:41 Check it out and, you know, see if you can figure out why I got injured. You know, maybe we'll get to that point. But I think for now it offers the clinician a chance to be able to analyze someone's running gait. So you get that kind of objective information. And then maybe they can use that over sort of repeated visits if they're looking at trying to retrain someone's gait or if they're looking for you know, some changes due to the intervention that they're applying, whether it's strengthening or gait retraining or something else. So I think that it gives us another tool really to measure something dynamically that, you know, until now we could only really do in a specialized biomechanics lab, which as he said, is very expensive and time consuming and really maybe only giving us a snapshot.
Karen Litzy: 17:40 Right. Right. Versus being able to see the bigger picture of a runner. Yeah. Yeah. Very cool.
Chris Napier: 17:49 And also, you know, maybe some of the work I'm doing is looking at monitoring, training load and you know, if you're kind of familiar with the training load research there's this sort of concept of internal and external load. And you know, the external load might be the number of kilometers or miles that you run in a week or the number of minutes that you run in a week. And the internal load would be some sort of intensity measure or rate of perceived exertion. And so, you know, my interest is, can we get a bit more specific perhaps about that external load. So we're not just looking at minutes or miles, but we're looking at you know, cumulative impact and that actually got a paper in review right now where we looked at that using the run scribe sensors, which are little pods you put on your laces on your shoes and they can measure shock, which is sort of a result of impact force results in acceleration when you hit the ground.
Chris Napier: 18:56 And we looked at whether there's a difference between looking at just a cumulative minutes, you know, run versus number of steps versus cumulative shock. And we found differences and with the cumulative shock we're going to know a deeper analysis. I'm not sure where we're looking for, are there changes depending on the type of run that the person did. So is it more specific measure? When someone is changing the terrain they're running on or changing their intensity on a regular basis? If someone goes and runs the same route every day at the same pace, then we're probably not going to get more information by a cumulative shock. But if they're running in trails one day and roads the next day and then they're doing interval workout or then they're doing a long run we might get more information out of cumulative shock or some similar measure as opposed to just the minutes or miles that they run.
Karen Litzy: 19:56 Right. Yeah. So just adding another element to, again, the overall picture of that runner. So like for example, like you said, you could have someone who says, Oh, I ran, I run 10 miles, I'm just making this up 10 miles every week and I haven't changed how many miles I run. But yet they're coming to see you for patellofemoral pain. Or maybe they're coming to see you with anterior shin pain. But what you're not getting is, well, I run the same amount, but this time I did on a trail and this time I did it on concrete and this was on a rubberized track or something like that. So I would assume that with that shock, you would be able to kind of see the difference and then as a therapist say, Hey, I don't want you to stop running, but maybe let's stop doing X, Y, Z.
Chris Napier: 20:52 Yeah. It allows us not only to look at what has happened, but also to prescribe in the future. Right. So potentially we can then say, okay, we need to keep that cumulative shock below a certain level or, you know, increase it gradually. And so if that's something that they can monitor on their own outside the clinic. Great. and I've done that a little bit with some people just more experimentally at the moment. But I've had people who are really interested in sort of tracking that. They've done that and it's actually been quite successful so far.
Karen Litzy: 21:24 Yeah, no, it sounds very reasonable to me as a therapist and certainly as I would think for the runner because, you know, oftentimes when runners get injured and first of all, they're told to not run. That doesn't go over very well.
Chris Napier: 21:42 No, no.
Karen Litzy: 21:46 And it's also not just the running, but it's part of stress-relief. It's part of what makes them happy. And so to be able to say, Hey, listen, we're collecting all this data on you and this is what we found. This is what you can do. I feel like it gives control back to the patient or to the runner so that we're not spinning. Right.
Chris Napier: 22:07 Yeah. There was a great paper just published last month that essentially looked at what their runners do when they can't run. Right. So if they're injured and they can't run, what do they do? And the answer was, Oh no, they didn't do other activities. They just say they just want to run. And that sort of, I think validated your feelings. You know, when you talk about cross training and, you know, go get on the bike or go on a full run or a swim. But I mean, the greatest thing about running is you can put on some running shoes and head out the door and you can fit it in anywhere, anytime. So it becomes much harder to fit in that exercise when you have to go to a pool or go to a gym, get it done.
Karen Litzy: 22:51 Yeah. And then I would think it must be even harder for some, not all, but some runners to get back to running after an injury. You know, there's fear involved there. They don't want to get injured again. They may sort of taper back to the point where maybe now they're not even happy with their running.
Chris Napier: 23:16 Yup. Yeah. And often, you know, we prescribed like a walk run program to get someone back in because it's sort of graded impacts. Right. So again, looking at that key middle of shock is what we're trying to do there is gradually someone back in to doing that. Even if they've kept the fitness even if they have been on the bike or something like that when you get back after prolonged period off of running, it's still, it can hurt, right. Of the impacts you don't get in other activities. And so again, that's where, if we can measure that and monitor it, I think that's a big advantage.
Karen Litzy: 23:53 Absolutely. Now before we get to the book, which I want to get to in a second, are there any other cool tech things when it comes to runners that may be you've worked with or that you've seen? Maybe not, you know, in the lab that you are in, but that might be coming down the pipeline that we can as runners or as healthcare providers we can kind of get excited about. And the answer might be a lot, but you can just pick.
Chris Napier: 24:26 Let's say a lot of the kind of more research grade or maybe not a lot, but some of the more research grade companies are starting to shift I think a bit more to a clinician or consumer level products. And one reason for that is the hardware is just getting cheaper. So, it's possible. And then also I think you know, the ability to fit these into or integrate these into apps where you have the visualization side and you can actually easy interpretation of the data. I think that's you know, we're going to start to see more and more of these devices available in clinical settings and consumer settings. And I think one that comes to mind is I measure you, is basically an IMU inertial measurement unit that now owned by VI con, but you know, they're starting to I think offer products that are a bit more clinician friendly where you can get real time feedback.
Chris Napier: 25:40 You can stop these on someone's tibia and have them run in the clinic and get some real time feedback and visualize it and give feedback if they're reaching certain thresholds. So if you're trying to keep them and you're trying to get them to run softly, for instance, you can get them to run. And this'll give you feedback when they're going over a certain threshold. Another, a Vancouver based company that I'm doing some research with. It's called plant Tika. This is actually their product here. It's just an insole. So you can just pop this into your shoe lacing. So on your shoe and in the bottom of it, I don't know if you can see here, but there's an IMU here. So it's very thin. Obviously it fits right into the insole and you don't really feel it when you're in there.
Chris Napier: 26:30 But it's a very strong piece of hardware and you can pop that into your shoe. And I say, well, that it's actually measuring that it measuring accelerations so it's got an accelerometer, but it's measuring that impact at that point where it's hitting your body so it's right underneath your heel. You know, and so we're doing some interesting work where we're looking at different footwear and how that changes the impact at that point, because today a lot of the research is using ground reaction forces, which are measured underneath the shoe, right? That's the shoe round interaction. Or they're using to bill accelerometers, which are, you know, measuring that force once it's gone through the foot and the ankle complex and is reaching the tibia.
Karen Litzy: 27:21 Some of those courses have already been disordered right through the ankle or through the shoe.
Chris Napier: 27:30 Yeah. So this is a cool tool and I think they're really keen to start using this. They're targeting clinicians because I think this is an easy one that you know what, I'm using it in the clinic right now where people come in. And when we did the gait analysis, I just slipped these into their shoes and just cause it's that much more information. It visualizes asymmetries really nicely as well. And, and they're also looking at beyond running. They're looking at you know, ACL rehab and that sort of thing as well.
Karen Litzy: 28:02 And are there any things you can think of that let's say your average physical therapist needs to watch out for? Right. So you have a lot of, cause I know you had mentioned more research based consumer products. I'm assuming that there are products out there that might not be the best things that we as consumers, you know, without naming names obviously, but things that we look at when we're looking at a company that's selling one of these like wearables and what their claims are.
Chris Napier: 28:35 Yeah. So I think first of all, the hardware has to be good. And when I say that, I mean you need to have a high enough sampling rate to be able to measure what you want to measure. So, you know if you have an accelerometer, that's a sampling it 60 Hertz for instance. If you're trying to, we capture that and you're gonna miss peaks of data and steps. And so it's just not going to be something that's reliable. You know, if you're measuring it at up at the waist crowds, then it's okay because we don't need high as high frequencies at the waist. So no for that we need to how you need to have a product that can sample at a high enough rate and there's papers out there that have looked at that, you know for kinetic and kinematic information, that sort of minimum requirement you would need.
Karen Litzy: 29:36 And what would that be? Do you know, off the top?
Chris Napier: 29:38 Perfectly genetic information and it's about a, you need like 500 Hertz for it could be more like 200 Hertz, you know, for the kinetics is going to depend on the placement for sure. But typically you want to aim for something that's about 500 Hertz, you know, a lot of consumer level products wouldn't have.
Chris Napier: 30:00 And then also something like the dynamic range would be important. And that's just essentially how many Gs they can measure. And so if your using a something that only measures up to 10 G then when you put that on your shoe and you're trying to, and, and there's impacts that are up around 20 G, then you're really not going to be capturing sleep. Right. It's missing that information again. So that, I mean, that's something to be wary of thought of it outside of the hardware would be looking at the output you get. And so some of these outputs you get are very general. You know, typically you'll have like a, you know, I put on my Garmin watch and go for a run and at the end of it it tells me I need to rest for, you know, 36 hours before my next effort or something like that.
Chris Napier: 31:00 And you know, I never really sort of regard that it doesn't really doesn't make sense. I can interpret that much better myself than relying on my watch. It also spits out a bunch of other metrics. You know, some of them might be useful. Others I would just sort of disregard and I think that's where, you know, probably clinical decision making comes into it. And having a knowledge of the activity and the person in front of you don't overly reliant on just sort of what the metric is outputting.
Karen Litzy: 31:40 So if you have, let's say a certain wearable on and it gives you again, making something up like 10 different kinds of outputs. I don't even know if that's possible, but you want to kind of take, is it sort of like you're taking what you need as it relates to what the patient's going through? Or are you buying something that says, Oh, it can give me all this information, so I'm just going to use all of it.
Chris Napier: 32:11 So, I mean, someone like me, I like raw data because I can play around with it and I can plug it into things. I can graph it and I can do whatever I want. And it's that raw data is, you know, the highest frequency and so the best data I can get, so that's what I want. But most clinicians don't want that because they won't know what to do with that data. Right. So it's gotta be processed somehow. And so that processing you can lose data and you can lose focus and you can have misinterpretations along the way. And so it can be something is it can be processed down to the point of where something might give you an efficiency score, right. Which is, you know, unit and listen in essentially meaningless where it says, you know, your efficiency on that run was good, average or bad.
Chris Napier: 33:08 Yeah. I mean that's something completely processed down to the end where it gives you this kind of, you know three categories. I mean, what does that really tell you? Probably not, or it could be somewhere in between. And so I think that's the hardest part here. And you know, what would be appropriate for a clinician isn't necessarily going to be appropriate for a consumer. So I think again, we're going to start to see products that are aimed more at clinicians and at more consumers as the hardware gets cheaper and more widely available and people are going to kind of sort through and find things that work for them.
Karen Litzy: 33:52 Right? Yeah. So I guess it's when it comes to the output, it's kind of like food. You don't want things to be overly processed it’s not good for you. Okay. Cool. Well now let's get to the book. So I'm just going to read. So the book again for people watching the book is called the science of running and it will be available on February 4th, but you can go to anywhere books are sold, Amazon or what have you and you can preorder. But I'm just going to read a quick description. I won't read the whole thing, but I'll read a quick description. Science of running goes further than any other running book to intergrate the anatomy. And physiology of the runner showing how running in walls and affects every system of the body, including the effect of oxygen on the muscles. The book breaks down the runner's stride, scientifically showing what's going on under the skin at every stage of the running cycle. Highlighting common injury risk based on a readers natural gait and showing how to correct them, takes a head to toe approach to 30 key exercises for runners, annotating the muscles, ligaments and joints involved, and showing how to perfect precision in those exercises to optimize their benefits. Sounds great.
Chris Napier: 35:12 I could have used more time.
Karen Litzy: 35:15 He probably did that in a weekend, but I mean, this is a very involved book. It's not like just a pamphlet.
Chris Napier: 35:24 No, no, it, it was a lot of work. I won't deny that. And it was a really interesting process for me. Essentially it's like what we just talked about sort of bullying down that kind of raw data or the raw science and being able to filter down to a level that's interpretable by kind of the general public or the, you know, the average runner. Cause that's essentially what this is. It's a handbook for runners about their bodies, right?
Karen Litzy: 35:55 So this is for the average person runner and for the clinician, right? So not like overly overly technical, but technically simplified.
Chris Napier: 36:08 Exactly. I mean it's not simple. There's a lot of information in there, right. And we've done our best you know, with the artwork and that sort of thing to be able to explain the science behind all of this. But there's a lot of information in there. I mean, it's not a textbook. And it's not an academic book, but it's very much for runners and clinicians, I think to have on hand. You know, whether it's in a clinical context, if you want to be able to explain, you know, an injury to a runner or you know, explain what you mean by you know, what's happening during running stride. There's a lot of you know, artwork and chunks of text in there that can kind of help to explain that. And for the average runner, I think it's sort of something that they can keep on hand and use you know, if they're training for a race or just in general or something to kind of, you know, refer back to over, over and over again. And there's also a whole chapter full of training plans. It was co-written by my coach Jerry Zack and again, that's a very comprehensive chapter there.
Karen Litzy: 37:31 Fabulous. And so I'm going to say it again, so for the people that are watching if you leave a comment or a reaction, you're automatically in the running to win a copy of this book. So please, you know, give a thumbs up or a heart or throw in and whatever like where are your lists, where you're watching from or listening in from. Because we'll pick a winner and I'll contact you when we're done with the interview and everything. But so when you talk about a book like this is there ever sort of misinterpretation of by someone to say, Oh, it's a book on how not to get injured when you run? This is a book on preventing injuries?
Chris Napier: 38:22 Yeah, I mean, yeah, I mean for anyone familiar with the research on running injuries, that's a pretty murky field at best anyway. I think what I tried to do in this book was present what the research does tell us and kind of show, you know, let's take foot strike for instance. Cause everyone knows about, you know, foot strike pattern and you know, we talked about, okay, what happens when you were first strike? What happens when you forefoot strike? And rather than taking the approach that one is inherently bad and we'll give you an injury we talk about, you know, how they affect your stride and where those forces go and that sort of thing. To be able to educate the runner on that rather than talk about, you know, this particular way of running will prevent injury. There's also a large section we've got about 30 different strengthening exercises in the book where you can you know, go through and again, it's a little visualize with artwork showing different stages of the exercises on specific running, strengthening exercises that you can do in the gym or at home.
Karen Litzy: 39:42 Awesome. Well, it sounds like it's a great resource for clinicians and the runner alike and are you going to, after doing this, and this was, I'm sure an arduous task that took quite a while. Are you going to write a followup in the works or are you like, Oh my God, let's publish this book.
Chris Napier: 40:02 I haven't really even opened this book yet. I got it. About three weeks ago, and I don't think I might've just opened at once to kind of flip through very briefly. So at this point I'm ready just to kind of keep it on the shelf and see what happens. But no, nothing in the works right now. I'm focusing on some other things right now and if that opportunity comes up, you know, down the line then perhaps a look at that then, but this was a very interesting process to go through. I have no regrets. I think it's pretty cool to see, you know. But I think I'll take a little break for awhile now.
Karen Litzy: 40:47 I get it. For you, as now an author, what was the best part of writing this book for you? Might've been like, as a person, as a clinician, as a researcher, what was like the big positive for you?
Chris Napier: 41:03 You know, in research we're always talking about knowledge translation, right? You have to kind of get that research to the end user. And how you do that. It's often very difficult for research. This gave me a lot of tools I think in my own field of how to get that research to the end user, whether it's a clinician or a runner themselves. So that's been really useful. Also I think working in the clinic it made me really think about what are the exercises I think are most valuable or what is the most useful thing that a clinician would get out of this book? You know, I'm often sort of pulling out a textbook to try and explain something to a patient who is in the clinic because they've got an injury and I'm talking about too much too soon or some of that. And I want to graphic where I can say, look, this is why too much, too soon is bad, or this is why, you know, running the way you're running might've led to this injury. And I'm often sort of ending up doing Stickman drawings or something to try and illustrate.
Karen Litzy: 42:14 Well we all do that.
Chris Napier: 42:16 Which is fine. But you know, this gives me a resource and hopefully others a resource in the clinic to be able to sort of say here like this is what I'm talking about and here's a nice sort of visualization and in some kind of bullet points as to what I'm talking about.
Karen Litzy: 42:34 Yeah. That's great. So I feel like it, to me it sounds like it's made you maybe a little more present, a little more thoughtful about what you're doing with runners and why you're doing it. Great. And I'm assuming that's also the goal of the book is have people be a little bit more present, understand the way their body works. This is for the runner, the way their body works and why they're doing what they're doing. And for the clinician may be taking a larger analytical view in as to the person in front of them, the runner in front of them, and maybe why they're getting the injuries that they're getting. And some options on how to rectify that situation.
Chris Napier: 43:16 Yeah, I mean, I think runners, runners are typically type a people, right? And they, you know, they get really into running and they want to know more and they want to learn like, okay, what's you should I have and what's, you know, what's the best way to run and what's the best way to train? And you know, so they're on Google and they're trying to get all this information. There's tons of conflicting information out there. Even from, you know, some of the top sources, right. Sort of the top sources for that. So again, hopefully this is something that kind of boils it down. It's very evidence-based and something that runners can rely on as a resource for all things running.
Karen Litzy: 44:01 Sounds great. Now listen, before we wrap things up, I have one last question. It's one that I ask everyone and that's knowing where you are now in your life and in your career. What advice would you give to yourself as a new grad right out of physio school?
Chris Napier: 44:18 So I would right out of physio school, I think just get your hands dirty and see patients, try and get lots of different experiences. If you're interested in sports, volunteer with teams. You know, don't expect payment right away for those things. Get out and work with people and put in the time and you'll learn a lot and those will turn into opportunities in the future. I think getting out and I'm not saying no to things is a big, big thing. And I think that's how I kinda got involved in working with professionals and sort of national team athletics. It's because basically one opportunity led to another. And I didn't say no along the way and so it just, you know one thing snowballed into the next thing. So I think you know, that's probably my advice. Just get out, start getting your hands dirty and get the practical experience and don't say no.
Karen Litzy: 45:26 Awesome, great advice. Now, where can people find you if they have questions and they want to find more info about you and about the book, where can they find you?
Chris Napier: 45:35 Well, the best place is on Twitter. I'm fairly active on Twitter and they can find me @runnerphysio on Twitter and they can contact me through that. Also if people have, you know, wanting to access any of my papers, that sort of thing. They can reach me through my email address which is Chris.Napier@UBC.ca. I'm happy to send along papers or if you have any sort of specific questions, I'm happy to answer them if I can.
Karen Litzy: 46:07 Awesome. And what we'll do is when this broadcast ends, I'll go back in and I'll put a link to your Twitter and to some of the papers that we spoke about today and a link to the book. So people want to preorder the book, go for it. For all the people who are on and who had some reactions or comments. I will pick a winner for someone to win Chris's book and you'll be hearing from me. I'll get in touch with you via Facebook. So, Chris, thank you so much for taking the time out and coming on to do a live and then it'll be on the podcast as well but to do a Facebook live. So thank you.
Chris Napier: 46:45 Well, thank you. I've enjoyed it. It's been a good chat and thank you also for all your work in the lead up to the world Congress with all your Facebook live interviews with a lot of our speakers. Cause that was really great to be part of that.
Karen Litzy: 47:02 Yeah, that was my pleasure. It was great. So everyone who's on and watching. Thank you so much and have a great couple of days and stay healthy, wealthy and smart.
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