EP152: "When Taping & Bracing Is Essential For Injured Athletes"

[00:00:00] Are you a motivated healthcare fitness professional? Are you looking to work with more athletes, become a sports specialist, or even get a job in a sports setting so you can finally enjoy the career that you've always dreamed of? If so, you're in the right place. My name is

[00:00:18] Chris Garcia, physical therapist, business owner, entrepreneur and residency trained sports specialist. I've been fortunate to work in professional sports and travel around the world working with elite athletes throughout my career and I've learned

[00:00:29] a lot of lessons along the way. I created this podcast to share my experiences and give you everything you need to know to help you become a sports expert. Welcome to the Sports PT Academy. Hi everyone, welcome back to the podcast. Welcome all

[00:00:47] new listeners and welcome back to those who have heard my content in the past. You want to know when is it essential to use taping and bracing for an injured athlete? You need to tune into this episode before I go on to the

[00:00:59] podcast. What is new? What is better in life? If you've listened to my last few podcasts, it has been a rough holiday, rough winter just with family illness and extended family and friends but we're always trying to see the positive. Life

[00:01:15] is great. I was in Ohio for about a week and a half for those who don't know. I did my residency at The Ohio State University so and I married the woman of my dreams, my wife Stephanie. She is from a small town outside of Cleveland,

[00:01:31] Ohio so we go there to visit and I enjoy the small town, just the small town feel. I love going back and it's just very refreshing to get some time away, be with the family. It did not snow for those who were asking. It was pretty

[00:01:51] cold. I think we're in the 40s but no snow so it was good to go away and hit a little bit of a reset going into 2024 coming off of the last podcast. If you listen to that, my kids are great. My daughter today just asked,

[00:02:05] Dad can I start playing the piano? We're going to navigate that and see if that's something up her alley. Let's see what else we got here in soccer. My kids are doing fantastic. My son Jacob, if you guys don't know,

[00:02:18] he's about two and a half years old and that kid's vocabulary is just skyrocketing. We actually loved it when he was nice and quiet too but now he is a talker. Family is all good, good reset and back to the journey. Let's go into this podcast.

[00:02:37] Why am I talking about taping and bracing? This is usually like a, oh I don't know if I would tape, I don't know if I'd brace. This is a topic that most people are like, I don't think you need it. As sports PTs typically you're like,

[00:02:50] what's the research say? What's the best for the patient? I don't like to tape. I don't like to brace because I don't want them dependent on these and this and that. This podcast is really about to stir the pot for those who are true believers in or

[00:03:05] non-tapers, non-bracers. We are going to go into when it is essential or at a high probability it's going to help this person recover and we are going to go through this with injured athletes and different scenarios and what benefit this brings them and why you might be

[00:03:24] wrong in what you're doing when you're missing out and not applying taping or bracing. So we'll go through that today. Why am I doing this is because I just got off a fiery huge first

[00:03:36] module of my sports PT Kickstarter for those who are in the course listening to this podcast. I appreciate all of you and I hope you walked away from that module ready to conquer the world

[00:03:48] on the next day in your clinical practice and figuring out which one of my patients can apply this stuff to. One of the things that we talked about was in the acute injury phases,

[00:03:57] when do you tape? When do you brace? In your clinical practice I'm going to take a step back and I'll explain how this all relates to like maybe I don't see those types of patients

[00:04:08] or whatever it is. I'm going to help you find there's a percentage of the patients you work with or athletes that you work with that would benefit from this and you might be missing out.

[00:04:20] I'll talk about a couple different regions and the types of braces that you might use as soon as next week. So let's talk about breaking down types of PT scenarios that you would see and I'm not going to talk about just regions. I'm going to talk about

[00:04:40] when you see people along the spectrum of tissue healing timelines. Now why is this important? After this first module of my Kickstarter we covered truly acute injury management and it's not very common for sports PTs or physical therapists who are interested in sports

[00:04:59] PT to manage these type of cases. Very rarely if you're typically in a traditional orthopedic setting you may have a patient get hurt, they went to the urgent care, they went to an ER,

[00:05:12] then they went to their primary care, then they went to a specialist and by that time it's three or four weeks in and they schedule an appointment with physical therapy and that takes one or two

[00:05:21] weeks so by the time you see them it's about four or six weeks after their injury. Now every one of you may have a different scenario and I completely respect that but I'm just saying

[00:05:32] that's a reasonable timeline for a patient to see you. If you are connected with an urgent care or you're connected with a primary care physician or a surgeon or you run a direct access, you have

[00:05:45] more direct access patients, good for you you might see this more often but for those who don't or do and you're like when would I, I mean I want to add more tools to my toolbox, when is it more

[00:05:57] appropriate to have supportive braces or supportive things to help this individual. Now obviously you don't want them to rely on these things and you want them to have the good you know stabilization

[00:06:08] and posture and the muscular strength and endurance to be able to do this on their own. Now there are scenarios where this is an outlier and you may need this to help get the outcomes that you want. Let's get one thing straight, our role as sports physical therapist

[00:06:24] is not to relieve pain. Our role is not to relieve pain and it's not to improve movement, it is not to get somebody strong, it is not to improve posture, it is not to improve gait,

[00:06:39] it is not to improve functional fitness, that is not our role, none of that is our role. Those are elements of the main role but our role is really to help people, help patients live a

[00:06:53] healthier more active lifestyle right and for some people that's a challenge because they continue to be active and do things and they always hurt themselves. So our job is not to get them out

[00:07:08] of pain, our job is to help them enjoy a life that they want to live right and that happens to be pain and if you focus at the very big room don't get laser zoomed in on an injury,

[00:07:25] don't talk about pain, don't talk about movement, don't talk about strength, don't talk about endurance. Let's focus on what is it that you do to help this person enjoy a better life, life without the aches and pains, a life without those things. Let's focus on that okay,

[00:07:41] if that's the case and you keep that as your target, your job is easier and when you determine when do you need taping or bracing that's what's going to help you. So let me give you an example.

[00:07:54] If you have a patient or an athlete maybe they were in a gym and maybe they do some type of functional fitness maybe there's plenty of types of businesses out there, F-45, Orange Theory, these type of businesses where they're doing like group-based classes or maybe they're doing

[00:08:13] their own individual thing and they're squatting and they feel a tweak in their back and they put the barbell down and they were hoping to be able to participate in a community style functional fitness competition with their friends like a group of guys or girls whatever it is

[00:08:34] and they wanted to participate in these things and it's in three weeks and the patient feels a tweak in their back and they're really scared and they've seen you before so they call the office

[00:08:45] and they're like hey I want to see you David, I want to be able to get in. You've seen me from my back before and I tweaked it here's the problem that I have a friendly competition

[00:08:57] with my friends in the next two to three weeks is it possible for you to see me today? Absolutely we'll get you in today at 4 p.m. perfect, get them in and now you're in a scenario where

[00:09:10] oh goodness this is a fresh injury this is not what I commonly see I'm used to seeing somebody you know four or six weeks who has poor st- core stabilization they have poor posture blah blah

[00:09:21] and this one's like wait a minute I can't even assess their posture because they won't even bend down to touch your toes or they have a gower sign as they come up

[00:09:29] from extension and you're like wait I can even do my normal assessment and now you can even look at just the back the question is that the patient's asking you is hey I want to be able to participate

[00:09:42] I understand my neck my back is messed up but do you think I'll still be able to participate in two to three weeks? Now that question can stump you because what they didn't ask is

[00:09:53] what's the cause of my pain they didn't ask when is this going to get better? They didn't ask well it is at my disc is it my sciatic nerve they didn't ask any of that so it took away your superpower

[00:10:06] your superpower is uh well let me see you move let me see how strong it is oh they took all your superpowers away and they asked how long do oh excuse me how do you think I'll be able to

[00:10:19] participate and at what level man that really takes pts to another dimension it really challenges our brain because we're not we don't process like that we don't think prospectively we don't think

[00:10:32] well I'm very confident I can get you there we think let's just take care of it now so in this scenario you have to figure out what other tools in your toolbox do you have besides movement and mobilizations that require a lot of active movement or corrective exercises

[00:10:48] now you're dealing with somebody who is very impaired and has a high pain threshold and they can't tolerate a lot and you're like well what am I going to do here for an hour? Now you have to

[00:10:59] figure out okay great what's going to reduce my risk of them having flare-ups or what's going to improve my outcome so they have the fastest outcomes to be able to get them back in the

[00:11:09] gym as fast as possible and now these are different scenarios and that's why I wanted you to zoom out and take the idea that we're going to manage their back pain stop thinking of that stop thinking of their hip mobility stop thinking of their hamstring length stop

[00:11:21] thinking about their psoas blah blah blah that's where we naturally go now I'm going to take all of your superpowers away and ask you what else would you do if this patient can't tolerate your hands it can't tolerate hip mobility they can't tolerate stretching because they're so inflamed

[00:11:39] and you just saw them day one of injury wow now that's a question can I even treat that what do I do why don't I just let them rest for two weeks well the challenge becomes if you let

[00:11:51] them rest two weeks what's the difference between you and the common you know association with like oh a primary care would just tell them to rest for two weeks well now you have that opportunity

[00:12:01] what would change if you had the dream scenario you had somebody day zero instead of telling you know saying that oh physicians you know I've heard this before that physicians they just tell them to rest and they should just move great now you have the opportunity

[00:12:14] now they're flared up and they can't move it just took away your superpower what do you do now now you have to think of all their alternatives so this all comes down to not just this framework or

[00:12:26] this this case scenario but ultimately it comes down to soft tissue healing and this was the the main topic I asked the entire group I think we have 30 we just had three people register in

[00:12:36] the last 24 hours a day after the event and I think we have 38 sports pts chiropractors pta's personal trainers athletic trainers inside the group with over 250 years of experience and so it's great conversations and I asked the group at the very end of it I said what's

[00:12:57] your out of the first two hours of the course what's your biggest takeaway and 90 percent of the group said soft tissue healing soft tissue healing that is the thing so I wanted to share how

[00:13:11] that relates to everything that you do inside your clinical practice now how can this help you even if you're not in the course what can you take away that everyone else has already has taken away

[00:13:22] within this course so let me get a little break down those who have had you know taken my courses and things that I've done in the past this is going to be a great refresher for you to be able to put

[00:13:34] this thing into context now so we look at soft tissue healing you know the first let's go back to like old school physiology courses the first 72 hours is the peak of the inflammatory phase

[00:13:50] this is where you know all of the repair processes platelets and everything are attacking things to either you know you know stop bleeding or open wound or you know if there's internal bleeding or if there's damage and localized swelling this is where everything is infiltrated the first 72

[00:14:07] hours and that's why people's you know joints or certain body parts they get inflamed and so this is a point where you really you don't want to risk a lot of things in those first 72

[00:14:19] hours and as clinicians we typically don't see this now if you work in urgent care you work in a a work very closely with somebody who does this or you're an athletic trainer and you work

[00:14:30] very closely with high schools or people that you can get referred to quickly that's great so the first 72 hours of the inflammatory phase the next phase is a proliferative phase which starts from like day four to about day 21 to 24 so the peak of the proliferative phase is day

[00:14:45] 14 so inflammatory phase is at day three and inflammatory and proliferative is at day 14 and the reason why proliferative is is peaked at 14 that's just a natural production of collagen and repair processes that come in that create you know a little bit the start of the scar tissue and

[00:15:04] this is why if you've ever wondered why you know post-surgical wounds it takes about 14 days for stitches to come out or heal or everything come together that's what's happening you're in the middle of the proliferative phase you're like the peak of it and once you get

[00:15:16] through that the start of day 21 is when you start remodeling right this is what we consider like the chronic phases and as you look at like the the peak of of the remodeling phase is around

[00:15:27] 28 to 35 days so it's about the four to five week mark and so this aligns with you know post operative care you know we know that the first three days you're really not seeing me

[00:15:38] what much people post-operative there's such a such in big pain and they're taking meds and right around the two to three week mark is when you see them because they're probably getting their

[00:15:45] stitches out those type of things and that's when you start more range of motion and you know light activation and then at four to six weeks that's when you can start to push it's all based on these three fundamental tissue healing guidelines and so typically physical

[00:16:00] therapists we only see people four weeks or after an injury because of the scenario that I started with at the start of this podcast most times you're not going to see them until they've gotten until the four week mark which is they're at the remodeling phase

[00:16:14] so as a clinician when you see people and you're like oh I wouldn't brace or anything else it's probably because you haven't seen them in the early phases and you're seeing them at remodeling

[00:16:22] so they're able to move they're able to do things you can actually evaluate their posture and do all these other things and they can do all of the corrective exercises that you want because they're out of the main two inflammatory phases and then proliferative phase and because

[00:16:35] of that I get that that's why you don't use taping or bracing often but now what if you had a scenario where you had somebody in those first zero to 72 hours in the inflammatory phase and

[00:16:47] you don't want them to reflare it up or aggravate it or you don't want them to fall or slip or you see them in the first 14 days when they're in the proliferative phase and they're they're just starting the process to build collagen and and actually have fibroblast

[00:17:03] come and create scar tissue so if that's the case if they don't have the stability or balance or that ligament is loose and it's not healed yet why would you start corrective exercises when they

[00:17:15] don't have the internal stability yet that would make zero sense think of a post op you wouldn't do that with an ACL you wouldn't do that with the meniscus repair you're going to attack it

[00:17:24] in a very slow progressive load potential now the great part with uh post surgical is that we have a lot of times physicians provide braces um you know hard braces hinge braces whatever that is

[00:17:37] and um that helps that already gives us a guide but now what if you had to determine gosh I don't have a physician to tell me let's assume this is not a fracture or anything bony pathology

[00:17:49] and not a complete tear now it's musculoskeletal and you can confidently handle that it's the dream world we want direct access yet we don't have the skills or confidence to manage through

[00:18:00] direct access so now what do we do so this is now um an easy way an easy outline to determine what types of brace you would use and when and why when we look at um bracing

[00:18:14] bracing has been shown to be effective uh in the short term with subjective response not with actual tissue repair uh of the shoulder the back and um the ankle and when we look at um bracing um there's two different types um there's a hard brace and

[00:18:34] there's soft braces and and there's hybrids everything in between there and um so when you're looking at hard bracing the things are hinged or they don't allow a lot of movement um uh like an extension brace underneath when you are doing when you have somebody who is injured

[00:18:51] and they have a grade one grade two um ligament spraying or soft tissue injury or a muscle strain so usually four to six weeks for grade one anywhere from eight to 12 weeks for

[00:19:03] grade two excuse me six to eight weeks for grade two and ten to twelve weeks for grade three and when you're evaluating these individuals and if you see them early in those phases

[00:19:14] when do you apply a hard brace when do you apply a soft brace because we're not talking about somebody who's in the remodeling phase who's four weeks out we're talking about somebody who is very

[00:19:23] fragile very sensitive and their early healing phases are not complete yet made they're maybe at day three they're in inflammatory phase they don't want to move that leg they're in day 14 that peak of proliferative and they're now just entering the remodeling phase your exercises

[00:19:38] your correctives are no longer usable until minimum four to six weeks until they're the peak of remodeling so because of that what would you do for the first 28 days what do you do at

[00:19:50] inflammatory what do you do at um uh proliferative and and at the start what do you do for four weeks what do you do for 28 days before they start remodeling that's where this gets tricky and

[00:20:01] you can't be with them all the times this is why virgin carers and primary carers provide slings and braces because even though you might say well it's better for movement I understand

[00:20:12] but they have to do this at scale they think is this person going to die on my clock and if it's pure musculoskeletal they'd rather just go safe with bracing it stabilizing them and then sending

[00:20:23] them out to somebody who can pay attention to them and work through and navigate which is our specialty fantastic the challenge is what if you had to handle them right now on your own

[00:20:34] would you have that confidence what type of brace would you use would you be stubborn and say oh bracing is not great yeah for post four week remodeling chronic pain patient well we're talking about a different human so um anytime that you're in the first three days

[00:20:50] inflammatory and up to the 14 day because you're in peak of proliferative is when you would use a hard brace a protective hard brace or a very stiff tape so for instance athletic white tape

[00:21:08] or luco tape these are very rigid tapes or a hinge brace where you have the most amount of protection and once you get past day 14 this is why postoperatively a lot of physicians or physical

[00:21:24] therapists will remove the brace at day 14 or they start to wean from it or they change how much they're actually doing is it waking hours at all sleeping hours whatever it is it's only because

[00:21:34] a soft tissue healing guy it's not just because uh you know time has has shown that it's effective well the reality is is that it's not just time or humans it's our natural cellular process

[00:21:45] so if you know what the cellular process is now you can provide actual days when you project to wean from things to discharge actual use of things versus saying I don't think bracing or taping

[00:21:56] helps whoa maybe it's shown in the chronic phases what about acute phases there's plenty of research to show it does affect people's outcomes and their ability to return to sport faster especially in ankles so when would you transition to a soft brace or a modified brace after day 14

[00:22:16] is when you can transition them up to day 28 so say for instance you've got a grade two ankle sprain you can do a hinge brace or a very stiff ankle brace that doesn't allow a lot of inversion

[00:22:29] eversion that's great for the first two weeks and then you can't keep them there because they're going to stiffen up no lose a lot of motion and then at day 14 you can wean them towards a modified

[00:22:39] brace from there when do you start to wean them from it comfortably at the four week market day 28 why because they're just passing and entering the remodeling phase so now you have

[00:22:49] progressions you have two week blocks where you can go hard brace or tape at zero to two weeks modified brace with a softer brace or tape from day 14 to 28 and then from day 28 then you can be

[00:23:03] the the the sports bt inside the clinic like you normally do and you never want to have anybody reliant on things you want to make them independent strong and great movers that's fantastic but what

[00:23:14] i'm telling you is your methodology and how you practice in the clinic does not apply the first 28 days why because they're sensitive and they're vulnerable and their tissue is vulnerable because they're just starting scar tissue formation because of their healing process so

[00:23:31] I titled this you know when taping and bracing are essential for injured athletes and it's not i'm not just saying it's regional based and you you know here's the best brace

[00:23:43] for backs and here's the breast brace for shoulders and knees and i'll let you search on amazon or you know donjoy or whatever you know website that you want to find the latest brace because

[00:23:52] by the time you listen to this podcast is recorded in 2024 if you're listening to this and 2027 2028 i'm sure there's a great fantastic brace that just came out that's better than the one from 2022 right so I think that you know the principle is the most important piece here

[00:24:08] don't put yourself in a corner um and and pigeonhole yourself to an anti-bracer and anti-taper your role in this whole process is not the region not pain not movement not coordination not endurance

[00:24:22] is helping somebody enjoy the things that they love in life and if this person this case that I brought up who has back pain and wants to participate with their friends in a friendly

[00:24:32] competition at a park or whatever it is your job is to say oh I don't even think it's possible I would just give up if it's in two or three weeks do the math let's assume let's assume

[00:24:43] it's in three weeks all you have to do is get past inflammatory at day three past the proliferate of day 14 and now they have a week to actually move and get strong so the question is you

[00:24:54] you're another response is that you can't participate it's you're only gonna have a week to really practice do you feel comfortable with that because I would put you in a um soft

[00:25:02] brace a compression brace or some type of a a brace around the um the low back only for the first three days and maybe start to win you uh in those first three to 14 days uh and then really just start working

[00:25:15] on core development but I'm not doing a lot of movement I'll get you past day 14 I'm only gonna have a week to really put you underneath load or a squatting bar and um that allows you to

[00:25:24] project and allow confidence as soon as the initial evaluation so when it's taping and bracing needed for sure in those first three days up to day 14 and you can start to wean or

[00:25:36] progress or work on modified things from day 14 to 28 and so if if so what happens if you don't do this you know our profession and I'm a big proponent of this because I really think that um we as a

[00:25:50] profession are going to shift in and what services we can provide especially in the outpatient ortho world I can't speak for neuro or peeds and that's not my specialty in my passion my obsession is sports pt and I really believe that we are probably only using 20 to 30

[00:26:06] percent of our total superpowers with what we can do for people who want to stay active and healthy in life and inside my sports p kickstarter pt kickstarter I have eight modules based on

[00:26:18] what I what what um even what the sports section defines as um sports pt whether it's like modalities or direct treatment or all these other things on the field care strength and conditioning

[00:26:31] injury prevention wellness care I mean all these domains and if we don't have confidence in all of those domains we can't service our community members if we stick to being a hands-on or exercise or corrective based movement based pt you're stuck in the clinic and it doesn't allow

[00:26:47] us to grow our arms into the community we can't work with urgent cares we can't work with primary cares why because if our skill set is only from remodeling phases from week four to week 16

[00:26:58] because that's when we see them post-op you're pigeonholing yourself you're you're in a corner that you can't service any other patients or athletes think about that your entire career is seeing people in chronic pain typically from week four to week 16 after injury and beyond

[00:27:13] if they have three years of chronic pain that's just a small window of what we can do for humans and and really make an impact in our community this this podcast was about what we can

[00:27:23] do for people in acute phases meaning you know your grandma your aunt your uncle's going to sprain their ankle the worst thing they can do is just like stabilize and do nothing your goal as a

[00:27:34] clinician is to figure out okay we what if we stabilize what else could we be doing to expedite their healing taping embracing would be one adjunct and it's just one extra superpower

[00:27:45] tool in your toolbox that you can be throwing into your cases that would just make the smallest difference so rather than being stubborn and saying I don't do that in the clinic what if I

[00:27:54] removed you from the clinic and you were now in an urgent care or primary care office you can't use that you can't say that how would you help these humans our goal is to help people

[00:28:04] enjoy life with less aches and pains and allow them to do the things they love I didn't say use taping embracing for pain management I didn't say use taping embracing for tissue inflammation reduction I'm just saying allow them to do the things they love

[00:28:20] and they might need this to supplement while they progress it back into the clinic and if you you feel that I'm getting fired up I love this stuff because I truly believe I've been exposed to

[00:28:31] this a large portion of my career I'm not an athletic trainer for those who are on this what are my credentials I'm a single credentialed physical therapist and my wife is a physical

[00:28:42] therapist and athletic trainer and you know I I had a lot of exposure to acute injury management I went through the residency at sports residency at the Ohio State University and it's where I worked with a lot of great phenomenal athletic trainers and sports physical therapists who

[00:28:59] who are SCS dual credential sync credential whatever it was and ultimately I really got to get hands-on experience for three years there and working with high schools and collegiate rugby

[00:29:10] and various sports and you have to get your hands what you have to have that exposure and then once I had that I I've traveled the world with United States Olympic Committee as their physical therapist

[00:29:20] and representing the the world's best athletes and I've traveled to you know 10 13 countries underneath them and multiple platforms world championships high level events and there's just so many scenarios where I realized that this exposure is so critical and the public

[00:29:40] doesn't know what a physical therapist is if you ask what a physical therapist is they're going to say well they wear a khakis Apollo and they give you exercises that's what they think a physical

[00:29:48] therapist is and I know we can change that perception our job is not necessarily just movement or correct size or pain management our job is to allow people to enjoy a healthy and active lifestyle without barriers with less aches and pains without restrictions and because

[00:30:06] of that I'm not saying you need to use tape and bracing for everything you need to know when it's a time and a place so when you service that same patient you have to be able to service them full

[00:30:17] circle not when they're just out of the remodeling phase now you are an incomplete sports physical therapist because you don't have that skill set you don't have to be an athletic trainer and if there's athletic trainers on here we there's amazing athletic trainers and if you

[00:30:32] don't feel confident with this you partner with them you figure out how to work together because it's not about professional boundaries it's about serving humans how do you serve more

[00:30:41] humans with a skill set you don't do you either figure out how to acquire the skill set or you find other people who have it and you work with them and you know that patient's going to

[00:30:49] benefit and that is what creates a community of healthy individuals that's what a sports physical therapist does it we don't just do exercises get that out of your head and today I just want you to understand you could be using taping and bracing for the three regions

[00:31:07] and the fourth I didn't mention was it's also been shown to improve pain reduction in knee knee pain subjectively but not tissue repair in either case if patients are able to feel better temporarily especially in these phases it helps them transition to more exercise based

[00:31:22] and progressive resistance and exercise and those type of things so why am I doing it because your community deserves it we don't have the full skill set but all you need is a better

[00:31:33] understanding to get your foot in the door to be able to manage these people so wherever you are I hope that helps if you're listening to this in the second week of 2024 if you're interested

[00:31:45] and still attending my sports PT Kickstarter I'd love to have you on board go ahead and send me an email dr.chris at drchriscarciad.com if you're listening to this recording after

[00:31:55] January 2nd week of January you can also do my take the same Kickstarter course it's just self study so it allows you to it's a it's the same modules it's just self guided there's a lot of homework

[00:32:09] assignments there's a lot of modules and it's a little bit of a time commitment but it puts you in a position where you're getting all the domains of a sports PT so if you're

[00:32:18] interested send me an email drchriscarciad.com or if not it is on my website drchriscarciad.com forward slash Kickstarter dash self dash study in either case if you love this stuff and you want to

[00:32:33] continue to thrive as a sports physical therapist consider joining my sports PT academy where I mentor physical therapists once a month and keep them in a position where they're growing and thriving and not just listening to podcasts and really actually throwing this into their clinical practice

[00:32:49] so that's for you the academy is the next step for you you can find more information at drchriscarciad.com forward slash academy other than that I hope you guys are thriving and enjoying life and absolutely crushing your patient outcomes and truly living your dream all right I'll see

[00:33:05] you guys on the next episode take care thanks for tuning in to the sports PT academy podcast it means the absolute world to me if you enjoy my content subscribe to the podcast so you know

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[00:33:27] great information to become sports experts if you have any questions reach out to my team at drchris at drchriscarciad.com and tell us exactly what you're looking for do you want more head

[00:33:38] over to my website drchriscarciad.com and sign up for my VIP email list to stay in touch with my latest updates on courses and mentorship programs if you know someone who would benefit from my content please share this episode with them until next time have an incredible day