My Story - To everyone out there chasing a dream

Hello everyone - My name is Lisa Reed PT, DPT and I am the founder of The Academy Physical Therapy. In light of all the recent changes happening in my life, I’ve decided that maybe I should share my story in hopes that maybe parts of it resonate with somebody out there who has doubts about chasing their dream. Until now, I have hidden these parts of my past because I was afraid that they would be viewed as weaknesses and I didn’t want to make excuses for my failures, but I’m starting to learn that they may indeed be my greatest strengths.

Its no secret that am 5 feet and 4.5 inches tall (yes, I claim that half inch), yet aspiring to be a professional beach volleyball player - although I never played indoor and the majority of my competitive sports background is in basketball, track, and gymnastics. 

I’m short even though my whole family is tall in part because my growth was stunted after I was born critically ill. My parents’ neighborhood burned down in a fire when my mother was pregnant with me. During this time, my mother experienced a pre-mature rupture of her amniotic sac, which resulted in me being born with a wide spread infection in every organ of my body. After over a month of treatment, the doctors in the NICU saved my life against all odds and gave me a chance to give this thing called life a shot.

I was a stubborn little thing, but my work ethic and stubbornness also earned me a spot on the varsity basketball team as a freshman at 4 feet and 11 inches tall. I never would have stood a chance without the help of my club coach, Carrick DeHart, who ran me through drills at 6am every day before school in 8th grade. Thank you Carrick for being the first person who taught me how to bet on myself.

My dreams of playing college ball were interrupted when my car was T-boned by a drunk driver during my junior year and I sustained a brain injury. I tried to hide my symptoms from just about everyone because “I was fine” and blindsided by my stubborn ambition to play ball. I rushed back to playing too soon against doctor’s orders, which resulted in several concussions in close succession. The cascade spiraled and I lost all hope of a scholarship offer.

Basketball was my first love and I fought my way back to earn a brief walk-on spot at the D1 level. I started as a practice player and eventually earned a spot on the team, but I didn’t play in a single game. The experience was short lived because I was cut immediately when they hired a new coach - let’s be real who is going to invest in a 5 foot 4.5 inch tall senior walk-on when they are trying to build a new program?! 

I found beach volleyball in college when basketball fell apart for me, and to be honest, I was horrible at first - just ask my long time friend, Miles Evans, who is currently playing beach volleyball internationally and chasing his own dream of an Olympic debut. Bless his heart though because he played coed with me anyways and tried to teach me the game.

While stumbling around the beach on my own, a local coach in Santa Barbara, George Richardson, came up to me and told me to my face that I was “horrible,” but he also said that I was “super athletic and had a lot of potential.” From that day on I was hooked - I worked with him every Tuesday for 3 years and played volleyball with anyone and everyone pretty much everyday while bartending at night to save money for physical therapy school. 

I only applied to PT schools that were in proximity to the beach so that I could continue to play volleyball. It just so happened that USC was the #1 ranked program in the country, but I chose it for location over accolades if I’m being honest. When I made the move to LA, I decided to live in Manhattan Beach so that I could immerse myself in the mecca of beach volleyball. I woke up at 4:30am every day to beat traffic and workout before school and spent the entirety of my limited free time on the beach.

While in PT school, my neurological deficits progressed and became something that I could no longer ignore - it became apparent that “I wasn’t just fine.” I hit rock bottom and almost dropped out of school, but thankfully I found a neurological PT specialist, Pam Ressler, who essentially saved my life. I was in neuro rehab for 4 years, and I still continue to do my program daily in order to function at my current level. Thanks to Pam and my PT classmate, Allie Southam, I not only finished the program, but I graduated towards the top of my class from the #1 ranked program in the country.

After graduation, I took a job in Redondo Beach which allowed me to still play volleyball to some capacity while working full time as a physical therapist. Thank you to my former coworkers and my mentors Ryan Yamada, Keisuke Kano, and Lisa Meyer who all helped me grow and develop as a clinician.

Just when I thought that “I’d made it,” I had an accident last year that resulted in a spinal injury. The physician in the ER told me based on my exam findings that the only reason I wasn’t paralyzed was because I “had a strong core.” I didn’t like the answers that the physician’s gave me, and so I made up a treatment program for myself. Although admittedly misguided by my stubbornness to continue playing volleyball, the program worked and I bounced back. Some of the structural damage is irreversible, but I can still compete at a high level as long as I remain diligent about my rehabilitation program.

Around the same time that I injured my spine, I also learned that I had a tumor in my left forearm - directly on my passing platform. My left hand was numb for the entirety of last season and it hurt like crazy every time I shanked a ball off of the tumor site, but I didn’t tell anyone because I was afraid that people wouldn’t risk playing tournaments with me if they knew. A few weeks ago, I finally had it surgically removed on NYE 2018. Thankfully, it was benign and I’m healing well, however the surgery was more complicated than I hoped and they had to remove my entire radial artery.

Although less than ideal, the whole process with my tumor gave me a push to branch out on my own and start my own PT practice with an emphasis in injury prevention, wellness, and sports performance - blending my passions for my PT career with competitive sports. It’s all uncharted territory for me, but I’m excited about what this next chapter has in store!

Thank you to my family, Dan, Carol, and Nate, and all of the wonderful people who have supported me along the way! Special thanks to my best friend, Cassie House, for accepting me exactly as I am, and challenging me to turn my whole world upside down to chase the dream - to “fail more and fear less” and embrace my failures the same way that I do my successes. Another big thank you to my coach, Jennifer Snyder, for pushing me to break through one ceiling after another, and opening doors for beach volleyball and my PT career that I never imagined would be possible. So I’ll finally admit it out loud without fear that it “sounds stupid” - I’m chasing the dream of becoming a professional beach volleyball player and a pioneer in the field of physical therapy and injury prevention!

Coming at ya 2019! ✌🏻

Why paying cash for physical therapy can be better for your body and wallet

A cash-based system allows for more individualized care and one-on-one time with your physical therapist. Instead of getting 10-20 minutes of face time with the PT and then spending the rest of the time on a heat pack and going through exercises with a PT aide, you get 1-2 hours of manual therapy and individualized exercise prescription with a licensed physical therapist. The benefits of corrective exercise prescription and instruction are often undervalued - however the goals of therapeutic exercise should be to correct the movement strategy that likely caused the injury in the first place, and to improve the strength and movement coordination within the range of motion gained following manual therapy. Physical therapists are experts in human anatomy, movement dysfunction, and corrective exercise. All accredited physical therapy programs in the United States are now doctorate programs, and therefore physical therapists are essentially “Doctors of Movement.” 

In contrast, there are no specific education requirements for PT aides, and therefore they are unable to provide the same level of expertise when instructing exercises because they do not have the knowledge base of anatomy, movement, and corrective exercise that a physical therapist does. https://www.ptbc.ca.gov/forms/ptaidsup.shtml Nevertheless, PT aides are prevalently used in many insurance-based practices because there simply isn’t enough time for the physical therapist to provide all the necessary manual and exercise interventions to the 15-30 patients on their daily caseloads. Working at this high volume also takes a toll on the physical therapist’s own body, which is somewhat hypocritical if you think about it because they spend all day trying to fix other people’s bodies at the cost of their own. https://covalentcareers.com/resources/physical-therapy-burnout/ 

So why such high volume if that is not in the best interest of the patients or the therapist? Well, often times insurance reimbursement rates are not high enough to sustain lower volume practices. Furthermore, contracts between insurance companies and PT providers are negotiated independently, and thus there are no standard reimbursement rates across different PT practices in the same sector - that means that different practices are paid different amounts for the same services. Insurance companies tend to give higher reimbursement rates to corporate, or hospital based systems because they have more bargaining power - however interestingly enough, these systems also tend to be the highest volume clinics and therapists may see as many as 4 patients per hour. This discrepancy in reimbursement rates and the lofty process involved to obtain contracts with insurance companies has led to a rising increase in cash-based practices. http://www.ncmedicaljournal.com/content/78/5/312.full 

When all is said and done, your out-of-pocket expenses within an insurance-based system may still be quite high, and might even exceed cash-based pricing although you pay a hefty insurance premium every month. Some insurance plans do not cover PT services until your deductible is met, or place a hard cap on the number of PT sessions allowed. Your co-pay alone may even be comparable with cash-based pricing. https://www.restorationspt.com/blog/pocket-costs-physical-therapy/ 

Our health care system is far from perfect and there is definitely room for improvement, but a cash-based system ensures that 100% of the money that you spend goes directly towards your care. Its up to you to decide what you value in terms of services and how you want to spend your money, but keep in mind that your body is yours for a lifetime and there is some truth in the old saying “you get what you pay for.”

Understanding The Human Body as an Integrated Kinetic Chain -PART 4 The Movement System

The key to injury prevention is understanding that pain is usually a result of a faulty movement strategy resulting in undo stress to the body’s tissues. The body must have adequate mobility and strength in all surrounding joints in order to execute the task at hand. Furthermore, the body must also utilize the right muscles at the right time to perform the movement efficiently and safely.

The logical question that follows is “how do we do that?” I wish that I had a simple quick fix for you, but the truth is that it isn’t that simple. I could give you a list of exercises to do with the goal of targeting the correct muscles, but there is no guarantee that you would use the right muscles to do them. Our bodies are very goal oriented in that if you give the body a task, it will use whatever resources it has to complete it - even if that means perpetuating movement patterns that are causing pain or injury. The other important factor to consider is that everyone’s body is different and therefore there is no cookie-cutter approach to fixing “low back”, “neck pain”, “knee pain”, etc. Re-wiring the nervous system to recruit the right muscles at the right time requires individualized care and guidance by a license physical therapist - and that is what I can offer you at The Academy. 


Understanding the Human Body as an Integrated Kinetic Chain - Part 3 The Shoulder

The shoulder complex serves as the anchor for the upper extremity much like the hip does for the lower extremity, however there are a few key differences. Both joints are ball and socket joints, however the ratio of the ball and socket sizes are very different. The hip is composed of a relatively large socket and smaller ball, whereas the the shoulder has a relatively smaller socket and larger ball. This anatomical difference makes the shoulder inherently less structurally stable than the hip. The socket of the shoulder is located on the scapula (aka shoulder blade) and the scapula and the arm must move in a 2:1 ratio during overhead reaching tasks in order to maintain the normal mechanics of the shoulder and avoid impingement of important structures like the rotator cuff and biceps tendon. Therefore, scapular strength and movement coordination is essential to maintaining a healthy shoulder https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3445067/.

Understanding the Human Body As an Integrated Kinetic Chain - Part 2 the Hip

Moving outwards from the spine and the pelvis, you have the hip joint which creates the anchor for the lower extremity. The hip is a ball and socket joint that moves in all three planes of motion. Mobility restrictions, weakness, and poor movement coordination at the hip are highly correlated with knee and ankle injuries https://www.ncbi.nlm.nih.gov/pubmed/29116830. The hip and the ankle act synergistically to absorb the shock of ground reaction forces during impact activities such as walking, running, and jumping. Failure to adequately absorb shock due to joint stiffness, muscle weakness, or a poor movement strategy commonly results in injuries to the ligaments, bones, and cartilage.

Lack of hip mobility, weakness, or poor movement coordination can also result in injuries to the spine - especially during flexion activities such as squatting. For instance, squatting deeper than your available hip flexion range of motion allows is a common mechanism for low back injuries such as muscle strains and disc herniations.

Understanding The Human Body as an Integrated Kinetic Chain - Part 1 The Spine

The spine and the pelvis are commonly referred to as “the core” because they are essentially the anchor for your entire body. Low back and neck pain are among the most common and debilitating injuries in our society, and so it’s imperative that we address the underlying pathology. Furthermore, if the anchor of the system is unstable, then a cascade of injury to the extremities is likely to follow. For example, elbow injuries in baseball pitchers have been linked to poor balance and core instability. https://www.jospt.org/doi/full/10.2519/jospt.2013.4680.

If you imagine the spine like a stack of blocks, there are small stabilizing muscles called multifidi that connect each block to the one directly above it. These muscles work to control movement of each segment relative to others and protect the disks, nerve roots, and ligaments around each vertebrae. Larger muscles span multiple segments of the spinal column and attach the top vertebrae to the bottom vertebrae, but may bypass the segments in between. In a healthy system, the smaller and larger muscles work together to provide stability and mobility to the spinal column. Structural injury and pain arise when the smaller stabilizers are over powered by the larger muscles - essentially resulting in shearing of all the structures in the middle when the larger muscles pull on the top and bottom vertebrae. Addressing this muscle imbalance is the first step to laying the foundation for a strong core.

The Fundamentals of Injury Prevention

The first step to preventing injuries is to understand what causes them. Your body is a well oiled machine that requires all parts to work together at the right time in order to move efficiently and safely. 

First, you must have the necessary RANGE OF MOTION available at all joints involved to perform the movement correctly. For example, in order to perform a common body weight squat, you must have enough mobility in your ankles, knees, hips, and spine. Stiffness in one joint can result in compensatory stress and potential injury to the surrounding joints. For instance, lack of mobility at the ankle or the hip are common causes of many knee injuries because the knee is located in between both joints. On the flip side, too much mobility leads to instability - which brings us to the next two components of the body system.

Second, you must have the muscle STRENGTH to execute the movement. In terms of our squat example - your glutes, hamstrings, quads, and calves (among other muscles) must all do their part to support the skeletal system and move the joints. Weakness in one area can result in compensatory overuse of another muscle group, or overload to the passive structures like the bone, cartilage, or ligaments.

The third component of the body system is MOVEMENT COORDINATION - or your body’s ability to control motion and use the right muscles at the right time to perform the movement efficiently and safely.  Much like an orchestra, you may have all the pieces to play a beautiful symphony, but the music won’t sound good if the conductor is off. Instead of a conductor, your body has a system in place called PROPRIOCEPTION which is essentially a feedback mechanism in your muscles and joints that tells your body where it is in space. You can train this system by working on performing each movement correctly so that your muscles and joints learn how to move in a stable way within the available range of motion. 

Finally, your body needs time to RECOVER in between training sessions. Even if your mechanics are perfect, the tissues need time to regenerate and there is no substitute for adequate rest.

Now that you understand the framework of the body system and the fundamentals of injury prevention - lets get started!