On Q Performance Therapy Podcast

This week, Dr. Mike Quintans is podcasting solo and giving a deep dive into his personal story of how he became passionate about helping people through physical therapy.

Mike grew up in Delaware County, Pennsylvania. He fell in love with helping all kinds of people recover from injuries when he was shadowing at an outpatient facility in the county. He went to Bloomsburg University where he played football and studied biology before heading to physical therapy school at Weidner University in Chester, PA.

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3:26 - Mike went through two ACL surgeries while he was in college, which gave him a good idea of what the recovery process was like.

6:00 - Mike was attracted to the stats behind physical therapy - “if the numbers look good, your bottom line is good, and people are recovering.”

10:30 - When Mike identified a gap in children’s care, he began dreaming up the perfect clinic. This dream became a reality when he partnered with Jim Fagnani from Physical Therapy Wellness.

15:50 - Within Delaware county, no clinics match the offerings at PTW Newton Square. Mike thinks there are some similar to his across the country, but most likely do not accept insurance. However, what it comes down to it, Mike says it is about finding the right team of people who care.

20:44 - Fitting the culture is important for Physical Therapists. Mike talks about his strategy behind hiring the right people.

23:10 - Ideal circle of life for a client and their relationship with Mike and his team. Mike discusses what he calls the continuum of care.

32:12 - Mike’s plan for the future is to keep helping people by expanding his reach and opening more clinics.

35:15 - Sports Medicine is another resource at his clinic through his colleagues Dr. Beatty and Harris sports medicine physician

37:01 - “We’re part of the game plan.” Mike talks about the relationship between the client and his clinic.

CONTACT

Phone - 610-723-7771

This week, Dr. Mike Quintans is joined by Dr. John Luksch, a board-certified, fellowship-trained primary care sports medicine physician at the Rothman Orthopedic Institute in Malvern and Glen Mills. Dr. Luksch specializes in the treatment of musculoskeletal injuries in athletes. His clinical interests include overuse injuries in young athletes, sports-related concussions, musculoskeletal ultrasounds, non-surgical treatment of injuries, and injury prevention. He has served as the team physician for a variety of high schools, colleges, and professional teams, including the Philadelphia Union (Major League Soccer).

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6:30 – He is starting to see more athletes in his office again, but not quite the amount he would during a regular fall. Some of the injuries he has seen post quarantine are from people who started a new physical activity, such as running, without anyone to train them.

11:15 – They discuss how student-athletes who have gone from sedentary lifestyles in quarantine to catching up on missed seasons and playing multiple sports at once are more at risk for injury.

16:30 – For growing and developing kids competing in sports, everyone is at risk for developing injury no matter what sport they are playing. This is why Dr. Luksch believes one of the most important parts of his job is to educate athletes, parents, and coaches.

22:22 – Dr. Luksch talks about the COVID-19 action plan for the college athletes he serves. For athletes who have tested positive, he sends them to a cardiologist to get evaluated.

26:50 – Dr. Luksch discusses what the potential psychosocial impact could be on high school students who are missing out on the social experience and camaraderie of sports. Dr. Quintans adds in how young people develop their maturity throughout high school and college, so losing these sports experiences may be taking away from some of their typical development.

31:35 – Dr. Luksch explains what apotheosis is and the effects it has on young athletes. Additionally, they discuss how some injuries can go unsee on the field but are obvious when conducting specific tests – like the lunge matrix – in the clinic.

39:30 – The doctors discuss appropriate recovery times which are usually a minimum of six weeks to allow the reduction of inflammation. They also talk about how important it is to maintain physical therapy practices after athletes return to sports from an injury.

44:55 – Dr. Quintans brings up some of the research about "return to throw" protocols for baseball athletes. Dr. Luksch suggests that athletes vary their activities and spend a period of at least 3 months away from their sport.

50:00 – The doctors brainstorm about what screening tests they can use in their own practices to ensure they are getting the full medical picture and to improve outcomes for their patients.

54:45 – Educate and empower. Dr. Luksch describes that whether someone is a sports medicine physician, athletic trainer, physical therapist, or strength conditioning coach, at the core of what all these people do is educate and empower.

CONTACT

Rothman Orthopedic Institute – 1-800-321-9999

Twitter – @drlukschsports

This week, Dr. Mike Quintans is joined by Paul Graham, a teacher and football coach at Penncrest high school (Mike’s alma mater) in Media, PA. Mr. Graham played football at Ursinus College where he was a two-time captain and all-American. Since then, he has coached offensive line, defensive line and served as the offensive coordinator for a number of high schools around Pennsylvania. Currently, he is the defensive coordinator at Penncrest.

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03:36 - Graham talks about what it is like transitioning to Penncrest from his previous coaching position at Garnet Valley high school, one of the top football programs in southeast Pennsylvania, where he had nearly 90 wins in the 9 years he coached there.

06:39 - Graham and Mike reminisce about their experiences in high school. Graham played high school football at Upper Darby, an extremely diverse school right outside of Philly.

10:00 – The left tackle from Rowin University was Graham’s white whale – the player he put himself in competition with to keep himself motivated. He says that all athletes need to pick their own white whale to drive their competitiveness.

23:24 – When school and sports were canceled, Graham and his fellow coaches came up with unique ways to keep their athletes in shape from home. Their solution was to create different programs for athletes based on their access to gym equipment.

32:39 – Find a way to get it done. This is the approach Graham and the Penncrest football team took when they started weight training together again outdoors.

40:39 – Graham talks more about what the at-home workouts looked like when the US was still fully shutdown. Mike asks how parents and kids responded to this new kind of training.

46:46 – As president of Media Little League, Graham worked alongside other board members who happened to be doctors. One was a pediatric doctor and the other was an orthopedic doctor who serves as the team physician for the Phillies. He talks about how he was able to utilize their medical recommendations when thinking about what actions to take at Penncrest.

50:22 – Mike asks what Graham is most excited about for the upcoming season. Additionally, Graham talks about how his coaching style has changed over the years.

59:39 – Graham discusses the safety concerns around football, and when he first let his own kids start playing. He also talks about the positive impact that playing a team sport like football has on a young person’s growth and development. More specifically, how football builds empathy by bringing together people of diverse backgrounds.

CONTACT

Twitter – @pagraham90

This week, Dr. Mike Quintans is talking with Dr. David Webner, a board-certified sports medicine and brain injury medicine physician at Crozer Health Sports Medicine. His main areas of research include endurance sports medicine and sports concussion.

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02:19 - Dr. Webner works with recreational, amateur, and professional athletes of all ages. He is the team physician for the Philadelphia Union, Widener University, and Interboro high school.

03:10 - Dr. Webner and his fellow practitioners serve multiple high schools within the Philadelphia suburbs as the team physicians. They are the go-to people for anything related to athletes, illness, and injury.

04:45 - As a primary care sports medicine physician, he looks at every aspect of an athlete from cardiac and neurological issues to emotional health. Drs. Quintans and Webner agree that anyone who moves their body beyond their daily activities is considered an athlete, and can benefit from sports medicine.

07:51 - One third of his patients are primary and secondary school athletes, one third weekend warriors to college athletes, and one third are the elderly population.

14:53 - Dr. Webner discusses some of the successes and challenges he faced as he helped restart Major League Soccer - the first professional sport to start up again in the wake of COVID-19.

25:14 – While high school athletes do not have as many resources against COVID compared to professional teams, there are still ways to return safety through social distancing, wearing masks, and practicing responsibly in pods.

28:04 – Dr. Webner discusses which sports he thinks are safest to return to play, and what measures all athletes can take to return to sports safely. He discusses multiple ways to deal with the discomforts of wearing masks while playing sports. Some of these include: bringing multiple masks to switch out when they get too sweaty and taking water breaks away from others so you have a chance to catch your breath without a mask on.

35:53 - Dr. Webner describes some of the after-effects of COVID on people’s health.

40:34 - People who have symptoms after they’ve “recovered” from COVID need to be looked at closely by a cardiologist to see if there is any heart damage. Myocarditis is an inflammation in the heart muscle that can lead to arrhythmias (abnormal heart rhythms) which are potentially life-threatening.

44:00 - Parents should have an open dialogue with their children and pay attention to their activity levels - if they are suddenly laboring themselves to play sports, go on a walk, or run around the house, then that is an indication they should see a doctor.

50:30 - Dr. Webner talks about the degree to which sports will return in the fall, and how accountability will play a large role in this. He offers advice to organizations on how to approach decision making when it comes to sports and COVID protocols.

58:28 - A good rule of thumb for athletes returning to sports after recovering from COVID is to take it gradually.

CONTACT

Crozer Health Sports Medicine | 610-328-8830

https://www.crozerhealth.org/providers/profiles/w/david-webner/

This week, Dr. Mike Quintans is chatting with elite performance coach, speed coach, movement specialist, and running guru, Tracy Peal.  He works in individual and group athletics by analyzing sports biomechanics.

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04:08 - Tracy Peal is a Philadelphia native and played football, baseball, and basketball as a kid, although he gravitated more toward basketball. He got recruited by Penn State from Salesianum High School where he got All-State. After a couple of years, he went to University of Delaware to finish his sport and education.

05:30 - After graduation, he started running half-marathons and getting into powerlifting.

06:22 - Tracy Peal also has a love for food and cooking.

09:00 - One of the biggest tools Tracy uses is his iPhone camera. He records a runner’s gate and breaks it down on video.

10:00 - Tracy likes to go to the athlete’s home turf. It’s easier to understand an athlete’s issue on their turf or track than in the clinic.

13:00 - Tracy Peal studied the Pose Method in early 2000s.  Dr. Nicholas Romanov, Ph.D. taught him everything he knows with running mechanics.

21:21 - The Pose Method is a general movement theory based on the idea that we are in a gravitational field. Movement is all two things. Gravity is body weight, body weight is potential energy. Free falling is the kinetic energy. There’s an up and down from potential energy to kinetic energy and back. Your job is to un-weigh yourself from the ground. If you weigh yourself quickly, then you can get yourself into the next post for the body to fall again.

24:00 - The quicker the body catches up to your foot, the less chance of injury.

27:20 - If you’re a heel striker, it means your hips are too far behind what’s landing. It’s taking too much time for your body to catch up.

29:30 - Take Usain Bolt. People think he has such a long stride but, in reality, his foot is landing below himself the whole time. Posturally, it’s perfect.

30:40 - Mike and Tracy talk about running cadence.

33:00 - Tracy explains how he starts when working with a new client.

48:00 - Tracy sees many more athletes than just runners. He’s worked with lacrosse athletes, archers, divers, etc.

CONTACT

Instagram - @tracypeal

Facebook - @tracypealspeed

Twitter - @tracypealspeed

www.pealsportsperformance.com

01:50 - Mike Keenan has worked in outpatient PT and sports performance since 2008. He specializes in vestibular conditions including sports concussions.

02:17 - Steve Vandenberg has worked in outpatient neurological rehabilitation over the past 6 years as a PT supervisor. Steve is an ImPACT trained PT specializing in concussions.

03:40 - What is a concussion? It’s a traumatic brain injury. They’re classified them on a spectrum from mild to severe.

04:30 - Symptoms of concussion: The first place to start is that no two concussions look the same. It can be challenging to assess which services should be appropriate because there are so many symptom combinations.

07:30 - Sometimes, patients don’t get to specialists until symptoms lessen. This can make concussions challenging to diagnose. Some providers still push rest. That’s great, but you have to see a specialist. Research is continuing to change.

10:40 - Concussions don’t always happen from a direct impact to the head. It can also happen through an impact to the body that affects the brain movement.

12:00 - Parents, teachers, coaches, and team doctors should take a close eye on their athletes, even if it’s a seemingly minor impact. An athletic trainer should spot some symptoms like unsteadiness, athletes looking confused, etc. They should do an on-field assessment and retest in about 5 minutes. Symptoms can be delayed so retesting is important! They should then be reassessed at 24 hours.

15:00 - Blinking of the eyes can also be a symptom. Usually, this is because of vision focusing or sensitivity to light.

19:30 - 70% of concussions will recover with relative rest within the first 24-48 hours and recover naturally with gradual re-exposure as tolerated. The other 20% — 30% are the patients we see in the clinic that did not recover naturally.

20:30 - If that 20%-30% gets their concussions diagnosed early, there’s research that with treatment, they can get back on the field sooner. For those in the 70% group, assessment won’t harm anything. Insurance can get in the way of seeing a sports medicine doctor with experience in concussions right away. The ATC should be able to give a recommendation.

27:40 - You have to be 24 hours symptom-free then do an exertional activity. If you gain symptoms from exertion, then you just have to repeat the cycle of 24 hours symptom-free.

40:00 - What should we be doing better with concussion management? One area we can improve on is “return to learn.” There are CDC guidelines for “return to play” and getting an athlete back on the field. Getting someone back to the classroom effectively is just as important, if not more important.

56:30 - Everyone involved in an athlete’s care needs to be informed. The PT should have direct communication with the athletic trainer.

1:06:00 - They guests don’t believe in concussion prevention. You can’t technically prevent a concussion. But there are things like peripheral vision and neck strength that can help reduce the risk of concussions. How to head the ball in soccer or tackle correctly can also help.

Dr. Mike Quintans sits down with Dr. Brandon Eck, Doctor of Osteopathic Medicine and an avid athlete.

03:00 - Dr. Eck grew up, essentially, on Penn State University’s campus with his parents involved in medicine and athletics on campus. His father was a PSU athletic trainer and his mom was a PSU physical therapist.

04:50 - Brandon got to meet players such as LaVar Arrington, noting that he remembers that his shoulders were wider than his locker. Seeing and knowing players like Kyle Brady and Kerry Collins were the highlight of his childhood.

10:00 - Dr. Eck practices a team approach, including the athlete, to decide what treatment is best for the athlete.

12:06 - Dr. Eck always wanted to play Penn State Football. In high school, he worked on his skills.

14:20 - Dr. Mike Quintans asks Dr. Eck if he had a son, would he let him play football.

17:20 - Dr. Eck believes in late specialization. High performing athletes typically played multiple sports at a younger age. The more you can be exposed to in youth the better.

21:30 - It’s important to have a balance. Too many repetitions of anything can lead to degeneration of a bone, tendon, or ligament.

22:30 - There are a number of ways you can attack stress reduction. There’s sleep stress, mental stress, etc. You might have more leniency with an injury like tendonitis than a concussion. You need adequate water, nutrition, sleep, etc.

28:00 - Medical providers have challenges sometimes with parents overtaking the conversation. It’s helpful to get kids in the room by themselves without the parent. This allows the child to take control of their health without mom or dad around. The bias of mom and dad is very strong.

31:00 - Athletic trainers should have a conversation with parents during the preseason and offer a plan of what will happen if an athlete gets hurt. This avoids parents stressing, sending their child to urgent care, and potentially receiving misdiagnoses. Having a laid out plan defining which sports medicine doctor an athlete should see, for example,  takes away the pressure on the parents to find adequate care.

38:20 - Dr. Eck works in concussion management as a traditionally trained sports medicine physician. He also works with general sports medicine management, athletic/non-athletic injuries (joint pain, tendons, ligaments, neck pain, back pain, etc.), and nerve injuries.  He has special training in ultrasound-guided injections. He’s also trained as an osteopath where he learned everything a regular MD would but got a little extra anatomy, manipulative techniques, and other osteopathic techniques.

46:14 - Dr. Quintans and Dr. Eck talk about one of Dr. Eck’s passions: cycling. Unfortunately, the sport is linked sometimes with performance-enhancing drugs. Performance-enhancing drugs (PEDs) are more to do with the monetization and culture of the sport than the athlete’s character. There are side effects and physical and emotional consequences of using performance-enhancing drugs.

56:50 - Dr. Quintans and Dr. Eck talk about their dream clinics. Dr. Eck wants a space where he has on-site physical therapy, 3D cameras, sensors, a sports nutritionist, and sports performance. He’d also love a multi-specialty approach with access to a network of sleep specialists, cardiologists, surgeons, etc.

CONTACT

LinkedIn DM: Brandon Eck

Listen to Part 1 of Dr. Mike Quintans’ conversation with Jordan Quinones to learn a little more about Jordan’s background and sports performance and strength and conditioning philosophies.

02:50 -  Jordan doesn’t subscribe to a strict trendy philosophy when it comes to fitness. He takes bits and pieces from his past experiences to make something unique. From his time with Crossfit, he utilizes the group mentality motivation, and comradery when it comes to fitness. From his Olympic weight lifting background, he applies the power explosive movements to their fullest extent in the workouts. From his gymnastics work he’s done, he incorporates the bodyweight holds and exercises into his workouts as well as the single-leg and balance work. Finally, from the traditional strength and condition background, he uses the sprint and speed work. He takes the team mentality and applies it to the small group mentality.

04:37 - “Any good strength coach will tell you, they take the best of what they’ve experienced, what they learned and as long as they can digest it and put it out there in an understandable manner… they use the best tools they can.” - Jordan Quinones.

05:30 - “It’s the ability to be humble and know that and know that you can learn from any given moment, from any given athlete.” - Jordan Quinones

07:00 - Advice to young sports performance coaches. Coaches have to focus on what the athlete needs, not what you like to do or want them to do in programming.

15:20 - Fundamentally, what is the basic goal of the day if the client wants to be a better athlete? You want a typical athlete to do a push, pull, hinge, squat, run jump, etc. They don’t necessarily want to win in a back squat competition. You need balance in addition to strength.

16:35 - Be prepared to change your program depending on what the athlete has coming up or how they feel that day. It’s important to be upfront and let the athletes feel they can trust you. If, for example, they didn’t sleep well the night before, they won’t excel in high-intensity programming. Always modify it if needed!

22:25 - Jordan goes through waves every 3 weeks going through higher reps and lower reps. As the weights get heavier or reps get lower, he includes tempo work. This varies day to day though! He’s on week 3 right now for this cycle. He’ll work assault bike first, then some kind of jump, throw, or sprint (JTS). He wants to put the dynamic movements (med ball slams, timed sprints) while there is still high energy. JTS is the time where you’re bouncing around, being an athlete, and being explosive in the workout. Jordan and Mike talk about different kinds of “throws.” You want the athlete to move in various planes of motions.

27: 30 - After JTS we get into strength work. That can be a front squat (lower body, knee dominant), banded row iso hold (upper body isometric pull), and plank hold (midline/anti-extension). Need adequate rest with only 3-4 sets because this is high weight strength movements.

29:35 - Then balance the rest of the day. This can include a landmine press (upper body press), single-leg RDL iso hold (hip dominant), and a single-arm carry (carry). Jordan loves the carry as a functional movement. On a Monday on week 3, you just want the athlete feeling confident.

31:10 - A density means that we’ll set a timer and your quality will dictate your pace. Let’s say it’s a 9 minute pace. With a timer, athletes move a bit faster so Jordan makes sure that the movements aren’t as complex. It adds a bit of stress. There’s gotta be time where you have to perform under fatigue.

32:12 - The first week of this would be maybe front squat for 5 and an upper-body pull (maybe TRX row) instead of a hold.

CONTACT

Instagram: jq.training

Email: [email protected]

Coach Conlan is back with Dr. Mike Quintans to talk about the challenges of coaching high school athletics.

02:00 - Coach Conlan, as a high school basketball coach, has challenges sometimes with private school recruitment. They can recruit public school athletes and help them reclassify to get an extra year of high school. Sometimes you see kids go to three different high schools in 3 years.

06:45 - The main reason why a parent would want to move their child to multiple schools is that kids want to join powerhouse teams as well as increasing the challenges of getting a scholarship to a good school. Kids may have falling outs with coaches as well.

09:40 - High school athletes are promoted to colleges through Amateur Athletic Union (AAU), social media, highlight tapes, etc.

10:50: Overtraining and overuse is always a challenge for high school athletes. With AAU teams, you’re essentially playing for a college scholarship. If it meant sitting out of a big game, sometimes kids won’t be as open with injuries.

12:20 - If you want to play with AAU you have to know your body as an athlete. Parents, you should keep an eye out for your kids to see if they look a little off and have consistent, honest conversations with them about how they’re feeling.

13:30 - Dr. Mike Quintans pitched an idea to do 9-part basketball-specific movements that could help to predict possible injuries. They looked for weaknesses in ankles, knees, hips, etc. and gave each player specific exercises or stretches they had to do before every practice that was tailored to their weaknesses.

17:30 - The Strath Haven High School Basketball team, coached by Chris Conlan, had zero injuries this year except for a freak accident when an athlete fell and broke his wrist.

19:15 - You can always tell the kids that are doing what they’re supposed to do. They’re always on time and are rarely injured.

21:00 - Sports medicine is so important. When Coach Conlan and Dr. Mike were in high school, they might not have caught things that we can catch now. Now it’s widely understood what tightness or muscle compensation can do to the body later on. For example, a tight quad could indicate muscle compensation which could lead to a torn ligament if not treated.

23:30 - The coach should be in the loop with the athletic trainer (ATC) and be fully aware of the limitations or modifications for an athlete. On top of that, the team physician or sports medicine physician should determine what treatment should be made for the athlete and the ATC should execute the treatment (if it’s not surgical). Sometimes if an athlete goes to urgent care, communication may be muffled.

32:00 - College coaches are very interested in athletes that do well in the classroom. They care about character first, then sport. It’s tough for student-athletes because there are many challenges and distractions.

Dr. Mike Quintans sits down with Coach Chris Conlan to talk all about high school sports: strategies, buy-in, and challenges.

02:44 - Coach Conlan attributes the success he had with his student-athletes with the buy-in he was able to get from his team: buy-in with him as a coach and buy-in with themselves. They had to gain confidence before they could trust themselves and each other to perform at a level to win games.

05:20 - Coach discusses what it was like to play and win against his old high school coach once Conlan started coaching at a rival school.

06:20 - Building trust with your athletes is huge. Sometimes they’ll have fun, sometimes it’s going to be hard.

07:25 - Coach Conlan is a bit of a traditionalist in coaching where yes, he appreciates and sees the stats, but also trusts his gut. Consistency is important. He starts the same 5 guys because those guys earned those spots. It makes other guys want to earn that spot because it means that the coach trusts them.

10:20 - COVID-19 has been tough on coaches because they have to trust the athletes to work out and do drills on their own. As a high school athlete, coaching is a passion (you’re not making millions of dollars) so you’re thoroughly enjoying your time. So Zoom calls just aren’t the same.

12:45 - Basketball is fun because you can pretty much play basketball anywhere. But even though most parks have a basketball court, because of coronavirus, the rims have been removed. Coach Conlan encourages student-athletes to work in everything else important with basketball: footwork, dribbling, etc.

15:30 - Chris Conlan has encouraged the Herschel Walker plan: go for a run, do push-ups, do sit-ups. He’s even more worried about athletes in sports like football that are very strength-training heavy. The two discuss potential impacts COVID-19 will have on athletes in the coming months and years.

19:00 - High school athletics are so impactful because there is a strong community within the school. Athlete or non-athlete, they support each other. They know each other well.

CONTACT

Twitter + Instagram: @coach_conlan