The Definition Of “Resilience” With Gigi Giuliano || WBWL Ep 61

What defines “resilience”?

I speak with fellow physical therapist and orthopedic specialist, Dr Gina Giuliano about why it’s important to obtain resilience with your rehab, pain or injury, as well as how we empower our clients with it.

This is an episode for anyone struggle with mental health, fears and anxieties around their ailments or bodily decline, and overall wants to be able to bounce back from adversity.

Hope you enjoy this episode, and feel free to share it and give a 5 star rating to the podcast.

Transcript

0:01

All right. So welcome to the Won Body Won Life Podcast. Hi, I'm your host. Dr. Jason Won lifestyle physical therapist. If you guys know, I'd love to, I like all the time to bring in a new guests, people that I. Revere, I respect. And I know that can add value to what the one body one life podcast is all about, which is to improve your health, decrease pain but overall improve your resilience. And I think that's the topic that we're going to discuss today. As you can see, I have one of my guests here and I've known her for a couple of years now, but it's actually, we just started conversing and then she agreed to being on this podcast and I'd love to have her. Her name is Dr. Gigi Giuliano and welcome in. How are you doing? I'm doing great. Thanks. Nailed the last name. I know. Thankfully enough. I didn't butcher that one, but anyways, yeah. Do you mind just sharing before we dive into our topic, which is like the importance, the significance behind the word resilience, and I think that's such a large, very powerful, empowering, and profound term that we often use, and I've seen that some of your posts as well, but yeah, just tell people a little bit more about like yourself, what you're currently doing and yeah, like just tell us a little bit about. Just what's your why behind, like, why even started your Instagram and what you're doing for on social media? Yeah, sure. So I'm a cash practice owner, a physical therapist, obviously, and strength and conditioning specialist. So I treat. Primarily CrossFit athletes in my CrossFit gym. But I actually started my Instagram back when I was like a third year in physical therapy school. And I, at the time, was starting to branch out from what school was telling us was the right way to treat patients. And maybe what my CIs were also telling us was the right way to treat patients. I just wasn't Buying into all of it all that well And so I started looking around on social media and finding some amazing physical therapists that were posting this awesome educational content And so I started just honestly using it more as a learning platform than anything at the time And started my own page and was basically just trying to take what I was learning and you know Send it out into the world for any other Physical therapy students who might want it. So that's how it started. Now it's turned into more of just an entertainment page and lots of goofy physical therapy related stuff. But it's relatable. Hopefully people like it. I love it. I always get a kick out of it. The algorithm knows that I love doc GG content and they'll send me some some videos of cats talking together and some other things. But at the same time, I do appreciate that once in a while, you'll definitely dabble into really teaching people about your expertise, empowering people and how to get past their injuries, get past pain. So that's what we're talking about today. Let's dive into it. This word, what we should call resilience. Why don't you tell us a little bit about what that kind of means to you, what your definition of resilience is and how that kind of plays into the overall experience when we are treating our clients. Yeah, resilience at its heart is, adapting in the face of adversity and essentially bouncing back after really hard times and we could speak about mental, resilience, physical resilience, right? There's all sorts of areas in our lives where we want to be resilient. As they say, like smooth seas don't make a skillful sailor. So that's crazy. I have a dude in my closet. I have a poster. Of a boat that's going up a like large tidal wave and it's a smooth sea. Never built a skilled sailor. That is awesome. I, yeah, I like that a lot because I think a lot of times we can get caught up in this, if I'm strong enough, whether it's mental toughness or physical toughness, if I'm just. Super strong and tough. Nothing's gonna hurt me and I'll never have to wade through tough waters. And it's really the opposite. Like you don't know you're resilient until you go through those really hard times in life. And so it really does take that in order to mold us and develop resilience, unfortunately. So we have to go through it. It's part of life, the more you go through it and the better skills that you have to adapt to those tough times, the more resilient you'll be on the other side. Absolutely. You hit on already a lot of great points that resilience is not, we want to dive into the resilience of what it looks like and perceived in the patient's eye and how we do that for our clients. But resilience can be in many different factors. So whether we're coming back from, A hard moment like a family tragedy or coming back from an injury, a lot of that kind of gets metal together. We talk about this bio cycle social approach with which we're looking at the pain experience, whatever the person's symptoms are, but it's not just a manifestation of their. Physical symptoms. It's a manifestation of all their experiences or culture about their values and behaviors. But when we can empower them to be better to get past a certain tough time in their life, albeit whether it's an injury, that is essentially what resilience is bouncing back from adversity. So with regards to that, how does resilience play into kind of one's rehab experience? Obviously, you're a cash pay practice. So you have a lot of clients that come in with their own baggage and their own fears and whatever their own personalities. So how does resilience play into the overall experience of the client? Yeah, it is so important for the progress in their rehab journey. It's I'm sure as physical therapists, we've probably all had that patient who came in with a relatively simple injury, like an ankle sprain or something that we know should heal, in a period of time, given what we know about healing, but for whatever reason, they like, never healed or they're still battling pain and issues a year later. And then on the other side, we know that there's patients who had terrible injuries. But they managed to bounce back very quickly. And while there's obviously a lot of factors involved with both of those examples I think that the mental and physical resilience played such a big role, right? A lot of my clients, the stronger that they were before starting physical therapy, the easier of a time that they'll have getting back to their daily function, as opposed to the patient who never exercise a day in their life. And now they're all of a sudden battling some pain. Sometimes they just take a little longer. Their body hasn't really learned how to adapt in the presence of broken tissue, right? When we get strong, we're essentially breaking down muscle tissue, building it back up, so to speak. That's what an injury is like. And so our bodies have to be prepared to do that. So I think that, my patients, both mental and physical resilience are so huge to them getting better. On the mental side, man, like patients who just don't believe they're going to get better or they. Aren't confident that their body is going to do what it's supposed to do like that, that plagues them. It really weighs down their overall progress and it's hard to watch that as a physical therapist when they should be doing really well given what their injury is. So it's, it plays a really big role, unfortunately, or fortunately, depending on how you look at it plays a big role in their journey. For sure. And how do you differentiate those people that like, do you get a good sense of the people that are coming in and they're like, Oh yeah, this person has. You feel it out. This person has a sense of resilience or they bounce back from adversity and you treat them in a different way versus the people that are maybe not as trained or they've haven't gone through an injury. Do you treat them differently at all? I think regardless of how resilient we think someone is, I think it's still our job to try and. Foster that as much as possible. I think you'll definitely get a feel for which people need a little bit more handholding throughout their journey, or they just need a little more encouragement. There's definitely people who just tend to have that naturally, or maybe they've battled a lot of adversity in their life, whether it's previous injuries in their college career something like that. Like you get a feel for people who. have gone through it before and know that they're going to get better versus I, the biggest mindset challenge that I've encountered is people that like, don't believe the injury is going to ever heal. They like get stuck in this cycle of this is my new normal. And it's you just thinking that. Gets people so entwined in that cycle of things will never heal, therefore they don't end up healing. And yeah, recognizing what people need a little more of that education or encouragement on the front side of things can at least help so that you're not getting stuck along the way where you're making no progress with that person. For sure. Yeah, there's a lot of people like they, I appreciate the fact that we're both staying up to date with evidence. This fact of what we call like the bioanatomical approach, which is like every. Every pain experience is just strictly due to a ligament is due to a herniated disc versus we understand that it doesn't matter if a person has sprained their back 10 times versus the person that just sprained their back for the first time is, in a fear mongering state. The reality is that we can't look at clients and just say, okay, it's strictly just a disc issue, which helps. I find that can be a more so disempowering because you're telling them, Hey, you have a disc issue. They're being affixed to a label or a diagnosis, and that oftentimes breeds like anti resilience. They feel even more fearful knowing that they're given like a diagnosis. So with regards to. What I think we both appreciate Gigi is the fact that we love we love, I see you addicted to the gym and I'm like I'm in my own garage gym, like seven days a week. I love the fact that I feel like very resilient. But how does exercise, how are we using exercise as a tool to essentially breed that resilience? Yeah. And good for you for getting in there seven days a week with your crazy busy schedule. It's hard. It's really hard to make it a normal part of our lives, but. Just right there, like practicing what we preach is so huge, right? If we want our patients to feel really strong and resilient, then we sure as heck better demonstrate that in our own activities and habits. So I think we can use physical resilience to, safeguard against negative effects of aging, to safeguard against potential injury. And I'm a big, everybody probably knows I'm a big CrossFit fan. I CrossFit and a lot of my clients obviously CrossFit. But within CrossFit, they have these areas or they draw attention to all the areas of fitness, right? You've got strength, cardiovascular endurance, you've got flexibility, you got accuracy, power. There's all these different areas of our fitness that we can attack and the more robust we are in each of those areas, the more safeguarded we are against those negative potential future outcomes. So I think we if we can attack our fitness. In that way where we're really trying to be fit in all the areas of health and fitness That's a great way to bolster ourselves against any of those negative outcomes. Absolutely we definitely have to preach what we teach. And I think exercise Is one of the main tools of? It's been shown in research that, strength training and make sure cardiovascular endurance, it will steer away all cause mortality by a good 20 to 40%. It's insane. Just, I even heard of the thing called if you heard of Vilpa, it's a variable intermittent lifestyle, physical activity, just 3 to 4 minutes of getting your heart rate up can steer off like Diabetes and your risk of dying by anything by 15, 20%, just three to four minutes, that's all you need. And then like a doubles when you add in just nine to 10 minutes. So for these people that are time strapped, just adding those factors in allows you to be more resilient from a longevity perspective. But exercise I've had examples and maybe you have examples of. Obviously, some of the clients you've treated of clients that have a lot of fear mongering. They are very kinesiophobic there I've had a person with chronic low back pain you put you say hey, can you pick up this pencil off the floor? That's actually a test and they don't want to bend forward. They don't want to rotate They're like I got to keep my core tight. I got to stay as upright as possible for those people with the fear mongering states you can tell there's a little bit more of a psychosocial component And sometimes they're fearful of exercise. How do you is it all about the knowledge and education or, is it just about kind of test trialing the exercises and being with them and ensuring Hey, it's safe to do so how do you get somebody from such a fragile state into a sense of resilience and trying to do that in a, as fast as possible, but not, not pushing the boundaries in terms of what's outside of their comfort zone. Yeah, absolutely. And that fear that kinesiophobia like that permeates every setting, right? You could be working with like top athletes and there will still be individuals You're coming into contact with who have that fear So like it doesn't change based on your setting there and there will always be people who are fearful of movement Especially after big injuries, right? And so I do think like you said a lot of that verbal education is important I'm Thankful that nowadays there's been a lot of light shed on the words that we use as healthcare providers and we're shifting away from that, fearful language, your bones are out of place, your joints are degenerating, right? We're like using better language now that makes patients feel like they're a little bit more resilient. And I'm so glad that's part of it. The verbal education we give people is excellent, but. Yes. The education is, just that, and there's a lot of studies where people get just education and it doesn't change their outcomes or their beliefs all that much. So while we can give that to them and that's helpful, we should definitely demonstrate it by, sometimes it's we'll tell people, Oh, you shouldn't be afraid of movement, but then all the exercises we're giving them are very. Benign, very careful. And we're almost like demonstrating to them that we think you're fragile. We're not going to give you any weighted or loaded. We're going to have you laying on your back and doing some, easy exercises because we're afraid. So we have to make our prescription align with what we're telling them. But on the same flip side of that, if people are so afraid of movement, just getting them to move has to be our first step. And so sometimes using more of those non threatening exercises is going to be the entry point to getting them to move. There's a lot of hate for some of the, clamshells and bridges, but like that stuff can absolutely have its role in physical therapy. If that is getting your patient to move and that's a non threatening way to introduce exercise to them. Yeah, for sure. When you're introducing exercise, you have to meet them exactly where they are. You have to understand their goals. That's why such a really strong subjective is really important. If they're having fears of running, then, you're basically maybe not get them on a treadmill right away because they might think their knee blows up. But can you do certain exercises in a controlled setting like a gym or doing it with them where you're saying Hey, This, you're explaining the why behind, Hey, you're doing a reverse lunge because it's mimics the exact demands of it. So if you can accomplish a few triple extensions, or you can accomplish a few hops on a single leg that should give you, that should foster the resilience that you need, and then therefore you're segueing into ultimately, you have to be aware of their goals. So get them on a treadmill, get them to start running, right? Cause that, I've had clients that. I've had other clients with physical therapists and straight up, just, all they're giving them is Bridges clamshells, they're a marathon runner. I'm like, yes, while that might be not a bad option, but is it the best option? Are we actually trying to get their rapport on the very first one to two sessions that I've had clients with a meniscus care, be running on the first. And it just empowers them for the rest of our sessions to just feel accomplished, feel a sense of bravery, feel a sense of security, but also foster that therapeutic alliance, which, I, that therapeutic alliance, so critical. What does that mean to you and how does that play into breeding resilience? Yeah. The therapeutic alliance is so important. And it's funny because as a new graduate I would say that, but I wouldn't really know what it meant. And I think that sometimes early on in our career, we think that just being friendly, right. Just being able to maintain casual conversation and ask our patient how they're doing. We think that's enough to foster that, but it's really not. And it wasn't until I started seeing patients on a one on one hour long session, in person in a private room, it wasn't until I started down that road that I really started developing Actual relationships with my clients and that's I'm not saying that has to be the way all physical therapists do things But for me I was able to dig into more of the patient's why the why behind Why they have to go to crossfit five days a week and why even with their injury? They're unwilling to give that up, right? There's a deeper reason for that. They're not just pursuing crossfit. It's like maybe they have this long story and they lost a lot of weight. Now they're feeling confident and they don't want to give that up. There's always a deeper reason as to why somebody is in your office. And so I think that if we can develop a therapeutic alliance by getting to know their story and just letting them know that Hey, we're on your side, we get your reason behind this. And we're going to help you every step of the way to try and get you back to maintaining this lifestyle that you've created. That's where I think we can really shine as healthcare providers. It's something that makes us unlike any other, unfortunately, most other healthcare practitioners don't have the time that we have with our clients. Maybe they don't have the the same therapeutic lines that we can build. And so if we can do that, that just sets us apart and basically makes us a team player with our patient versus just someone they visit once a month or once a week, just to get. Yeah I totally agree with that Gigi, because I came from a setting I think I discovered you maybe like a few years back, but I started back in 2019 coming from probably the largest HMO clinic in the world, where pretty much it was all about, the first question you get is how many sessions can we build them for? That's like the very first question versus No, like how can we actually foster the relationship that we need in order to get them to a positive outcome. It's more about, about the numbers rather than actually treating the person. And I can tell because after 2 years of being there which I won't say the night, but like after 2 years of being there, it was. 15 to 20 patients a day. It was seeing a person like every two to three weeks to the point where I couldn't text them. I couldn't email them. I couldn't see how they're doing versus now we have. We both have practices where we're quite proud of our practice. We're quite proud of the quality of care that we deliver. And that's what people need. Ultimately, it's if you don't have the time or can't spend the time to get to know the person to foster that relationship, how do we expect to breed the resilience that they want and have good long term outcomes? Yeah, there's no way and people might argue with me in saying this, but if you're seeing 20 patients a day There is no way that you are building that therapeutic alliance with every single one of them There's no way you're getting any further than hey, how was your weekend this weekend? There's no way you're getting past that with That short of a treatment session and that many patients, there's just not enough bandwidth in our brains to, foster meaningful relationships with that many people. So absolutely. I think it's I'm glad that more clinicians are getting out of that and getting into practices. I think that's so healthy for the future of the profession and obviously for our patients, which is, the whole reason we got into this in the first place. For sure. I remember one specific time where I Yeah, It was almost my turning point of Oh, I'm going, I'm, I have to quit this and I have to start with which, which I started flexor Dr. J. And then I started my own thing, but at 4 30 PM, I was so tired because I was documenting so many clients. My last client, I was, I actually, it was like hot. Hi. And then I actually said it for I forgot her name just because I was so tired. I was seeing so many people. My brain was like documenting on 20 different people. And that's when I said enough's enough, if I want to if I want to help my clients to be as resilient as I want them to be and not have these, the short term easy exercises and really, and I also have more time to develop more custom strength training and immobility just because I foster those relationships. But yeah, that was my turning point. And I guess the other aspects of therapeutic alliance when you're talking about I think you dabble with it, like the nutrition and sleep side. How do we play, how do you marinate exercise with all the other aspects of health? And do you focus on that as well? Yeah, it is tough. Given our scope. I think it's physical therapists like our scope is a little broader than many people give us credit for and it depends on our program and what continuing education we dive into. But some of us have some additional coursework in nutrition, right? Some of us have our strength and conditioning certifications and some have orthopedic certifications, right? We have a lot more than just the pure musculoskeletal physical therapy education that we were given In a traditional school and so I think like we absolutely should try to encompass some of that within our conversations with our clients, right? How is your nutrition? Talk to me about it. What is your protein looking like? Are you tracking that? And if it's something that we think we should refer out anyway, maybe it's a little outside our own comfort level, like by all means have your List of practitioners and specialists that you refer out to and that you use as your network with your clients. But I think that if we can at least involve those aspects in our conversations with our clients, at least they know that we care about it, right? If I don't even ask them about sleep at all, if I don't ask about their nutrition during their session with me, they're not going to think it's important to their rehab. They're not going to watch what they eat, right? If they're not already, involved in that area of their life and tracking and just being healthy they're not going to want to start now and they're not going to realize the role that plays in their healing. But if I am making a point to ask about it, it means that it's actually beneficial in their overall healing process. And I think that's a great way that like we as. PTS can bolster more or foster more of that resilience. That's just outside of the physical, right? If they are sleeping well, if they're nurturing their relationships in their lives, that's going to make them a more resilient human being, not just a more athletic, more fit. Less painful individual, right? I think that we as PTs care about all that stuff, but it doesn't always come across in our visits. If we're just focusing on the three exercises that I gave you last week. Did you do that? Yes or no? We have to ask a little bit more about the overall picture of health. And I think that we, a lot of us have the, education to do that. And, we're not stepping outside our scope at all. If we are going to start prescribing, that's where you have your referral partner. Okay. Exactly. How do you expect to bounce back from adversity if you have poor diet or getting three hours of sleep? So it's all interconnected. All of it. It truly is. I did have a client that she's she was postpartum rehab. She was she was having like low back pain and she, I think she was doing all the right stuff. She was doing her exercises frequently enough. She was doing good, for some reason she was like, ah, I still have this like SI pain. I still have this pain. That's I can't stand up straight. You start to dive into her sleep and then she's Oh yeah, my. My baby's going through a sleep regression. I'm like, okay there you go. And then another thing was like, I was telling her like, Hey, protein is, protein is one of the most critical things for for the anabolic stimulus to, or anti catabolism. And I said, track it for two days. And then you get, you come back to me, you see what's going on, and then again, just fostering more of the therapeutic Alliance by asking her every nuance of her health. And she's Oh yeah, I'm getting like. 60 grams. And I'm like that's less than 0. 4 grams per pound of your body weight. She started to get 120 grams. She forced it in. And she's My energy levels are so much better. She's and my exercise feel really good now. I'm like yeah, it can be the missing link. Imagine how many therapists never ask, and that is one of the reasons their patients not getting better. And now the PT is thinking it's me. I'm a bad PT. They're not getting better than me. Or they're thinking it's the patient's fault. The patient isn't doing their exercises. The patient starts thinking there's something that you're hiding from me and I'm going to figure it out. Yeah, we have to be willing to dive into those topics for sure. And even if we don't think we're the best person to handle, education on that topic, at least ask, you're at least going to get your client thinking about it and thinking about how those aspects of health interplay with their rehab in your office. Definitely. Going into another question, which is, I love how you're a practitioner that when I see you like working with their clients, I can tell by the way the words that you use in your post that you're all about what's best for the client and not necessarily keeping them as like a repeat customer. Or I understand that in order to have a thriving business, you have to have customers. You also got to get results. But at the same time, we're not trying to create you. Repeat offenders or get them addicted to our service by any means. So the question here is all about self efficacy. And I can define it right now. Self efficacy for me is like the innate belief installing that belief that they can handle their own symptoms. They can do it by themselves. It's giving them the belief, right? And that's another part that breeds and interconnects with resilience. So how do you get your clients to a point where essentially you can be like, Hey. You don't need me. So what sort of tools or what sort of strategies or tactics or principles you install into your clients in order to basically say you don't need me, forever. It's like you can do this on your own. Yeah, I think along the journey with them working with you, it's so important to celebrate the wins every time they achieve some range of motion every time they. Master an exercise that they weren't able to do the previous week, maybe they hit a new strength PR something like that I think celebrating those wins along the way Really demonstrates them how their hard work has been paying off, right? and I'll even like straight up say that to a lot of patients like look at how much your hard work is paying off like You're doing all these exercises. You're doing all this work and you're reaping the benefits And it's, I think it's a little contrary to the old school belief of I'm doing this as a physical therapist, right? That's my work out there. I mobilize that joint. Now you're able to get full range of motion, right? I think if we can show people how how to solve their own problems, essentially, they're going to value you as their practitioner more. Versus them, just leaving and being done with your services once and for all. And then that's a better way to win a client for life anyways. If they just think, Oh, they fixed me with a little snap, crackle, pop. And I'm good until the next time I need it. That's much less. valuable that if we show them how to manage their knee pain, manage their new onset, whatever pain, they're going to say, Oh, that's awesome. Now I have the tools to be successful. If everything, if anything comes back in the future, I'm going to go back to them if I can't solve it on my own, because she showed me how to solve it on my own. For sure. I love that. And, even though there's a lot of health practices that are predicated around How long can I keep them for right? And unfortunately there are practices out there, but you got to realize if you're letting them go you're teaching them how to fly on their own. They're going to talk about you. They're going to talk about how I was empowered by Gigi. And now I know I fixed my own. She's, that person can refer regardless, right? They're going to refer you to all your friends. But besides that the other aspects is I do a mixture of like, all, I do a mixture of online. And I always say to my clients that if we're doing this online, And I teach you soft tissue techniques and I'm teaching you these exercises and I don't do anything and I just teach you what to do. That means that if you get results, that means you did it by yourself. You essentially, you did it by yourself. And even if I'm in person, like I'm, let's say I'm doing a manipulation or I'm working on somebody on joint mobilization. They're like, Oh man. Your God said you, I feel so much better. I'd be like, yeah, you feel better. But now that opens up the window of opportunity to teach you something that you can do to mobilize your own joints. Full Merlin lacrosse ball work, anything at all. And that's essentially saying now that we've opened up that window for you to move better, now let's strength train. Now let's shut the door on pain. Now let's teach you your own soft tissue techniques so that you can do this by yourself. I think it's like one of my favorite things to hear. If a client says oh, yeah, I was dealing with a little bit of that shoulder pain, before the workout, but then I did some of the exercises we talked about and it was better. And it's awesome, like you're learning that the things that we're going through in our treatment sessions are going to benefit you and you don't need me for those. You just need some guidance in the initial phases. And then it's yeah, you can be resilient all on your own. You can learn to become a resilient human being with just a little guidance to get started. Yeah, for sure. The other thing that I do is just it's basically boils back down to like when we were doing like chemistry class or biology and it's like you propose a hypothesis, you perform an intervention and you see what happens. That's what I do with my clients is like if they have. A shoulder flexion deficit and you're like, Oh man, my shoulder's pinching at the top. And then you say, Hey, why don't you try to activate your customer? You're doing like maybe one, just one exercise, right? Don't try to meddle it, but one exercise and be like, okay, now, put that down now retest. And all of a sudden they're like, Oh my God, my shoulder's going 30 degrees higher. It's we'll see, like you did that by yourself. Now, you know that if shoulder flexion hurts. Install this, right? Do this exact thing. And it's just great to have people think about their bodies in this way. If I have knee issues, I could do X, Y, Z. If I have a low back issue, I could do X, Y, Z. But yeah, I know that we talk about these individual parts, considering that we're taking a whole body approach taking the whole person into account. Are there other factors that we haven't talked about that may Essentially breed more of that resilience. Cause we talked about fears and anxieties and maybe exercise. That's one of those catalysts to prove resilience. Is there anything else that we haven't covered? Yeah. I think our health is made up of so many different components and like we've said they're so interconnected. And actually because it's the new year, I actually just completed a vision board earlier this year. And one of the things I did, I'd never done this before the first time, but one of the things I did is I wrote out all the different areas of health for the most part, right? We have physical, we have mental slash emotional, we have financial, we have spiritual, right? We have all these different areas of health. And so for me in the new year, I was really wanting to set some specific goals. In each category. And so as physical therapists, we primarily function in the physical domain. I just think again, just having conversations with people, seeing how they are doing in all those other areas of health, because that all contributes to their. Being in resiliency. I think it's just awesome to be able to talk about all those different areas and see how people are doing with them. And I will say that's a kind of a fun way to do the if anyone does a vision board or even just writes out goals for their future. It's cool to see all those areas and how they interplay in your life. It's sometimes it's like when my relational health is doing really well, then all of a sudden, like my physical health is doing really well. Or if I, if one area is suffering, then it's Oh, other areas are starting to suffer. So it's cool to see everything laid out and try to, make progress and all of them versus sometimes we think about goals and we just have I want to hit a PR in the deadlift and that's all we focus on, but it's why don't we get all the areas of under control? And that's, one awesome. Goal that we can accomplish, but it's just one piece of the puzzle. I love how you did a vision board. I haven't done one in a while. I know I did a vision board when I was when I first started my business and some entrepreneur was like, Hey, do a vision board. I was like, cool. Why not? So like I threw on like a big house, I threw on like a Tesla in there and all of that at the end of the day was unrealistic. And I did none of that, those things, although I have a new house, but yeah, that, yeah, but the. There, there's a book that is mainly it's a financial book, but I, it's called balance by Andrew Hellam. And that book talks exactly to what you said, which is, yeah, these kind of four quadrants of health, one of them being your financial health, your relationship health, your physical health. But also he said that another one that people don't really talk about is it's your purpose. It's your purpose on, in terms of why you're doing what you're doing, because without purpose. Why are we here on this earth? I think that when it comes to the patient experience, when we're talking about these Some of these clients have had years of pain and they don't know how to be resilient or you're trying to foster that, but it's so difficult. There's a lot of things that I rely on. One being like knowing your why, right? Simon Sinek, this Canadian author says, you know what to do, how to do it, but if you don't know why, and I think that's a huge part of resilience and that's a part of my resilience too, in terms of where I came from when I started my business. Who knows what their business, your business can implode, your business can suffer, but, knowing your why and be like, Hey, I have a greater vision to help more people in the world. Or if it's your goal to get back to playing sports, like why, why are you interested in getting back to that? Oh, it's because, I want to play with my kids. Oh, why do you want to play with your kids? Because I love them to death and I never want to say no. So there's when you start to ask. More outside of like the subjective questions, just like the superficial, Hey, what hurts? But you start to ask more along the lines of like, why are you doing this? Why are you working me in the first place? And you start to dig deep, like peel the layers of the onion. You get them into a place of such emotional certainty Oh yeah, this is why I'm doing this. And all of a sudden that starts to breed. A shit ton of resilience that you never would have gotten if you didn't get to the core root of like, why they started in the first place. Absolutely. Yeah. And that was a turning point for me with my business too. When I was working both jobs, I was still in the clinic full time, but I was doing the side hustle in the CrossFit gym part time. And my turning point was the reason the moment when I realized my purpose was when the people that I would see one on one in the CrossFit space were starting to open up about some really deep things, right? Depression, eating disorders, things that, you're not just going to tell someone you're seeing for 15 minutes. That was the moment that I realized, man, I'm going to make so much better of an impact in someone's life if I can be a listening ear. For an hour session, right? Whether we're still getting physical therapy things done or not. If I can listen and be another healthcare practitioner that is actually hearing and talking through this stuff with somebody, that means so much more than if I see 20 people and I make. Marginal physical improvements in each of their, physical bodies. It's just, I'd rather have one person who feels comfortable opening up to me about some past dramas and that using that as a gateway to heal their physical issues that we're dealing with. I just, that's so much more fulfilling. And so that was the moment when I also wanted to go. out and do that all on my own and leave the clinic. And so you're absolutely right. I think some of that deeper stuff is just so important. And if we can be the people to hear that and foster that conversation, that's huge. Yeah. Yeah. So when you're looking at certain practitioners, like I obviously I got dog Gigi on here for a reason, because I know that there's definitely people that I want on this podcast that are actually doing the right things to. Foster relationships to build resilient to breed resilience, and ultimately it does start off with the therapeutic alliance. I read a study that said that 50 percent of the big thing of this, like 50 percent of them of the predictability of getting a positive outcome comes strictly from a therapeutic alliance. It means that you could be the most skilled manual therapist, the most therapist. Skill you could give the best exercise in the world, but without actually fostering the therapeutic alliance. A lot of that's Nolan Boyd. You're leaving. It's basically it comes to a flip of a coin is 50 50. But when you truly get to know someone develop that relationship, you're asking them all the right questions. You're getting to actually know them. I'm not saying know their family, but know the nuances of They're wise their desires that just allows so much more. And I think that besides exercise being one of the main catalysts for resilience, I think that it's good to really empathize with our clients and get to a deeper level that will ultimately allow them to be resilient longterm even without us. And I think having that purpose to honestly, it would probably cure a lot of the burnout that we see in our profession. I think that a lot of physical therapists haven't quite yet discovered that purpose. And they're just punching the clock every time they go to work. And it's not fulfilling enough to be a lifelong career. You have to find that purpose one way or another. Yeah. And at the same time I've, I forget there's somebody that I think we know. But he often said that sometimes, like PT it's like compared to other jobs, like sometimes it's not the most lucrative, like you gotta have a deeper sense of why you're doing this. Because this is not like a. You're not going to PT to be like, I'm going to be like a multimillionaire immediately. While some can get there at the same time, if you have a 50 K job, a hundred K job, and it's a job that fits the bill, but if it fulfills your heart and your desires, and you're saying to yourself man. I don't care about like making a ton of money. I just care about this person in front of me. I care about this person that this person that has so much fears and wants for their life and they just don't know how to get there is your, you're an important role in bridging that gap towards them at point a, and they're looking at point B, but there's no bridge because they have no idea how to get there, or they have fear that's stopping them is. You're an important piece in fulfilling their quality of life. You're changing their life, getting the back to crossfit or getting the back to running or getting the back to just playing with their kids. I think that's why I love what I do. And ultimately, that's why resilience is so critical because empowering them to fix their own issues and to be the best version of themselves. That's ultimately why we went into this profession. Yeah, absolutely. Man, that right there should be like a graduation speech for a DPT program just so they can hear some, seasoned physical therapist reason for staying in the profession because, man, it's sad how much we see new graduates leaving the profession already, so I love hearing PTs who are passionate about what they're doing and finding fulfillment in the work and just loving their patients because that's what it's all about. That's awesome. Absolutely. I don't want to take up too much of your time. I'm sure you have like patients and other people to see after this. But at the same time, I'd love for people to get to know you. If there's a place that people can find out more about you or, more about your practice where do they go and where can they find out more? Yeah. In terms of social media, Instagram is really the only one that I spend time on. Doc, gg. I try to keep up with YouTube. I'm just not. I don't like being on the computer all the time. So I'm working on it. But for right now, that's the main thing. I have a website for my company. My company is Raise the Bar Rehab. So raise the bar rehab. com is my website if you want to learn more about the company. But yeah I'm trying to be off the computer as much as possible while still, answering questions and making connections with people, which is exactly how this came about. Some of it's working. Yeah. And I can't even actually be on the computer very often. I have two kids and also I got to be in the gym. So I got to be outside, I got a lot of excuse for not being on the computer, but I'm sure Gigi, this was a great podcast episode and I, you bring such value to. Everyone's lives, including this podcast as well. So I look forward to fostering our relationship to building, potentially to doing this again and collaborating. But yeah, it's resilience. This is a really important episode. I hope that a lot of people got a lot of value out of it and yeah, if you want to listen or learn more about Gigi raise of our. I believe it's grace of our rehab, right? Okay. But anyways Gigi thank you so much for your time. Appreciate it. And for everyone else hopefully you can get a lot of value for this. All right. Take care and have a beautiful rest of your day guys. You too.