Welcome to Brian's Corner!  Every month I will have a featured guest who is in the sports physical therapy world or a unique entrepreneur in physical therapy.  

In today's episode, I interview Zach Cogen.  Zach is a graduate of USC's Sports Physical Therapy Division 1 Fellowship and current physical therapist at EXOS in Los Angeles, CA. 

In this Episode...
- Learn about Zach's story into physical therapy
- Learn about what USC's Division 1 Sports Fellowship is all about
- What Zach does at EXOS in Los Angeles, CA
​- Brian and Zach discuss Return to Sport and what is missing

                                             Learn how to make extra money as a physical therapist!

Have you ever wanted to become a paid physical therapy consultant?  Do you want to know what being a PT consultant looks like?  Are you looking for more control over what you earn as a physical therapist?

If you said yes to any of the above questions this article is for you.  I’m going to show you what being a paid PT consultant looks like and what that entails.  For the last two and a half years I have been a regular (every month) PT consultant for both a gymnastics gym and an AAU basketball team.  Being a consultant has been one of the most rewarding and fulfilling experiences of my career.  The best part about it is that I not only get to work with athletes but I get to control my income.  Educating athletes to show them how to improve their performance and decrease their injuries is when my best skills come out.  Additionally, being able to teach coaches how to affect change with their athletes is very rewarding.  

So what exactly does PT consulting look like?  I’ll give you an example.  The gymnastics gym I work with has me come in 1-2x/month depending on the time of season & my schedule.  When I go on-site I teach the gymnasts how to warmup properly (incorporating dynamic warmups, mobility work, strength work, and gymnast targeted exercises), consult with any athletes having pain or injuries, and educate the coaches on what I see can be improved.  I do not treat any athletes, I serve as a hybrid physio/strength coach teaching athletes how to take care of their bodies from a wellness standpoint.  I will screen out movements with many of the athletes who have aches and pains to show them why they might be having pain or loss of motion.  I will also demonstrate movements and exercises to achieve the desired goal (performance vs mitigating injury).  Finally, I will write out any programming that I may suggest them to do before or after practices during the weeks I am not at the gym.  
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The key with being a consultant is adding VALUE.  Many clubs/teams are not aware of how valuable physios are but understand that they need education/help to improve their athletes performance & reduce injuries.  This offers a HUGE opportunity for physical therapists who want to work with more athletes and create additional income opportunities for themselves.  In fact, you can also become a paid physical therapy consultant as there are so many teams, clubs, and high schools out there.  Understanding how to search for the right types of teams, knowing what kind of value you can bring, knowing the right ways to pitch yourself, and understanding the small details (legal, upsells vs cross-sells, etc) can help you become a PT consultant.

If you are interested in learning more about how to become a paid PT consultant see the FREE webinar I am hosting on January 11th.  Sign up here:
 https://brianschwabedpt.lpages.co/how-to-become-a-paid-pt-consultant-webinar/
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Or, if you ready to dive right in and make this year different my biggest sale of 2020 is going on right now.  You'll get this course for 35% to help jump start you as a PT consultant AND teach you everything you need to know to carry out athletic screenings with athletes when you become a consultant.  This sale ends January 9th! 

Become a PAID PT Consultant Course
​Use CODE: PT2020

Being a physical therapist doesn’t just mean you have to work in a clinic or hospital.  There are so many opportunities for us to gain control over our careers and also earn more money.  Stay tuned for more articles showing you different ways you can earn more money as a physical therapist.  

Dr. Brian Schwabe, PT, DPT, SCS, COMT, CSCS
Board Certified Sports Physical Therapist
IG: @brianschwabedpt

A few months ago, a PT student reached out to me asking about sports residency programs.  He wanted to know what my experience in one was like, how it helped my career, and what he should do to try to put himself in a position to get one.  This was not an uncommon question as I get at least 15-20 emails like this yearly.  However, my answer to these type of questions has changed over the last few years.  

What was my experience like in a sports residency?

If you would have asked me this question during my residency I would have told you amazing and also very stressful.  Now, looking back, I would still say that it was an amazing experience but I would also say I see there are "different" paths that can be taken depending on career goals.  What I mean by that is you can certainly create your own "residency" experience.  For example, if you are looking to work in a collegiate setting you may want to do a more structured residency experience with a university.  However, if you want to work in a clinic setting that deals with primarily athletes and does event coverage then chances are you can find a clinic like that while using the money you will make to create the type of education you want.  

How has a sports residency helped my career?

Completing a sports residency has done a few things for my career that I don't think I would have had without it.  The first being the skillset to feel comfortable taking an athlete from the start of rehabilitation to the end of rehabilitation.  I think that the orthopedic skillset that is required at the start of rehab is crucial but the understanding of the sport biomechanics, demands, athlete mindset, and proper loading progression to get back to sport is something extra I learned consistently working with my mentors.  The second way I think the residency helped my career is put me in a network of people I could learn from.  It wasn't just my immediate mentors but more the ones that I was able to reach out too being a sports resident that helped me get my foot in the door with them.  These people that I looked up to were more than willing to talk with me and while they probably have helped numerous other clinicians, I do think it helped that I was a clinician that chose to do a residency to advance my career.  Lastly, completing the sports residency helped me gain the confidence to treat any athlete effectively by understanding the return to sport essentials.  This has helped me advance my career by landing consulting gigs with gymnastic and AAU teams which has been very rewarding.  







What should you do to get into a sports residency?

I wrote a great article right after my sports residency interviews about this here but the main thing is do as much in the sports world as you possibly can.  That can include going to the sports section conference, volunteering at marathons, taking sports PT courses, taking additional internships in sports, and more.  The more a residency sees your passion for sports physical therapy the better. Lastly, make sure you reach out more than once to these directors or go visit them in person.  This is a great way to stand out.  

​Overall, doing a sports residency is a choice.  You can certainly build out your own "residency" experience by choosing your own education, using the extra money you earn as staff PT to travel to meet more sports clinicians, and volunteer in your local community at events.  However, structured residency experiences also have there advantages and can certainly make it easier to get consistent sports experience and mentoring.  

Dr. Brian Schwabe, PT, DPT, SCS, COMT, CSCS
Board Certified Sports Physio
USC Sports Residency Trained

Return to sport testing is still a process that is (in my opinion) under utilized.  However, part of the reason I believe more clinicians don't do consistent return to sport testing is because they are unfamiliar with the process.  The research has demonstrated step by step how to do many of the tests that have been validated and reliable but they don't show us how.  Fortunately, there are now many videos showing us how to do them (see here for example).  Yet, knowing how to do the tests aren't enough.  In this article, I am going to show you the benefit of performing return to sport testing batteries at multiple stages of rehabilitation vs one big return to sport test.  

In the past, performing hop tests was considered a good return to sport test.  However, we have learned so much about returning an athlete back to sport.  There are many factors to consider when returning an athlete to sport.  

                                                  "When will I be able to compete again?"

The first thing we have to do  is define what return to sport is.  Many still interchange return to play and return to sport.  The return to sport process must be defined by sport & level of sport.  For example, is the athlete a billiards player or a soccer player?  Furthermore, if we take the soccer player example is the player a recreational league player or an English Premier League player? These questions must be answered when considering return to sport.  

Now that we have defined return to sport, we have to understand all the possible contextual considerations.  Those can include the following:

​- Type of injury (acute vs chronic)
- Type of sport (individual vs team sport, contact vs non-contact sport)
- Level of participation (recreation vs collegiate vs professional)
- Physical demands (multi-directional, cutting, jumping)
- Significance of upcoming games (goes back to level of participation)
- Social & financial implications
- What is successful return to sport? (being on the field performing vs being the MVP)

As you can see, there is a lot to consider.  This is why return to sport has evolved to be a continuum.  The athlete evolves in the rehabilitation process from return to participation to return to sport to return to performance.  Educating our athletes and the other stakeholders (MD's, trainers, agents, parents, coaches, etc) in this model is crucial to avoid miscommunication and establish trust.  

This leads into the next step of return to sport which is the current models that help us with our decision making.  Those include:

1. StARRT Framework
2. Biopsychosocial Model

The above represent the paradigm shift towards criteria based approach to RTS vs time based approach.   For those that are unfamiliar with the StARRT framework, see the below picture.  In other words, step 1 asks us: how much load can the tissue handle? Step 2 asks us: how much load do we expect upon return to sport? Step 3 asks us: what contextual factors may influence RTS decision?

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The Biopsychosocial model further evaluates the athletes psychology.  We have learned over the last decade how important this is.  Without evaluating this, we are missing out on a big contributing factor with a successful vs non-successful RTS.  To summarize, the biological, psychological, and social components play a big role. 

As you can see, there is a lot to consider with return to sport.  This is exactly why performing one grand finale test is not efficient or enough.  We need to appreciate the continuum that RTS is.  Testing batteries should be designed to help us make better decisions about what we need to improve with our treatment & training program for our athlete.  Furthermore, being able to re-test can help us determine if our programs were sound enough to make a change.   In future posts I will demonstrate example testing batteries I perform with videos for better clarity.  

My question for you is: Do you regularly perform RTS testing batteries?  If not, why?  


Dr. Brian Schwabe, PT, DPT, SCS, COMT, CSCS
Board Certified Sports Physio
USC Sports Residency Trained