This week on the show we welcome Dr. Andy Chen, a physical therapist based out of New York City, to discuss principles, systems, adaptability, environment and constraints, the blending of performance and physical therapy, the importance of filling empty buckets, being patient when progressing a client, manipulating the task at hand to provide different learning opportunities, and the growth mindset needed for developing your own model.
Andy started lifting weights in his senior year of highschool, entering a local bodybuilding held by the school’s wrestling coach and gaining 30 pounds in the process. Andy continued to train but didn’t have a real focus on academics until he experienced his first injury in his senior year of college that required him going to physical therapy. From that experience, he grew to love the practice of physical therapy and went on to get his Doctorate from the University of St. Augustine.
We first dive into the differences in the principles learned at PT school and how Andy applies them as a practicing physical therapist. The University of St. Augustine was a very hands on manual therapy based curriculum, and while Andy doesn’t agree with it now, he’s appreciative of having learned that model early on. When it comes to learning new models and how to integrate them into his practice, Andy credits a course he took from Dr. Craig Lebenson for having taught him the importance of principles over systems, and now he looks through a lens of offering patients graded exposure to get them from point A to point B. He also mentions the likes of Dr. Ryan Chow and Dr. Jarred Boyd, who he works with closely, as further reinforcing the idea of using principles as the backbone of your model.
This leads us into a discussion on communication and being able to match the intervention with the client’s actual needs. Andy talks about how he puts an emphasis on building a relationship with his patients in order to help them build confidence and get buy in to allow for better progress over the long term. He wants people to enjoy resistance training, and that starts with making sure they’re comfortable and having a good time. Oftentimes we may not know the exact reason for a patient’s diagnosis, and the ability to look beyond what’s presented at the surface level, requires not only a keen eye but you actually need to care about the person in front of you.
Next we get into Andy’s big rocks and principles of his current model. The first thing he looks at is availability - or what is the patient’s body capable of doing. He then looks at adaptability - or is the patient able to thrive in different environments. Therapy is often done in a very controlled environment, but that doesn’t always match up with what a patient is going to experience in the real world. Andy wants to be able to get people into the positions that they need to be in and to be able to do so in different contexts. When talking about how he manipulates a task to provide new learning opportunities, Andy uses his recent experiences in track and field as a tool to get clients doing locomotive activities such as skipping and marching. He finds that these simple drills can be adjusted based upon what he’s seeing in order for someone to learn the same skill but under a different context.
We then transition into how Andy blends performance with Physical Therapy. He likes to think of the two on the same continuum, with improvements in performance leading to an increase in function and an improvement in efficiency leading to an increase in overall resilience. He looks at where you are right now, where do you need to be, and then he wants to provide a little bit of stimulus just beyond that. In terms of “filling the buckets”, Andy believes that sometimes the training needs to be qualitative such as movement competency, and other times it’s going to be quantitative in the case of rehabbing from injury and trying to return to play. He wants to find the lowest hanging fruit and then communicate with the patient as to why they are doing what they’re doing and how it relates to their goals. When it comes to building a movement portfolio, Andy looks at it from the perspective that having more options will allow you to have the ability to disperse stress instead of it all going towards one area. And while he wants people to feel good, Andy points out that it is OK to train when you’re in pain. You need to find what’s an acceptable level of discomfort and then layer in strategies to manage that pain.
When talking about his approach when working with powerlifters, Andy doesn’t try to make changes when they aren’t needed. A common example that you see with powerlifters is the ever increasing volume of training, but his point of view is that if something is working then there’s no reason to change it. In regards to pain, he will have clients dial back if the pain is causing them to change their movement patterns, either by decreasing total training load, using different accessories, or changing the lifts altogether.
Enjoy and be sure to hit that subscribe button if you learned a thing or two!
3:15 - Andy’s background
5:45 - Andy’s experience as a practitioner vs his time spent in PT school
9:10 - Andy’s Influences in how he practices
15:02 - The importance of communication and relationship building
25:32 - Andy’s big rocks
28:02 - How Andy manipulates the task to allow for different learning opportunities
31:50 - How Andy blends performance with Physical Therapy
43:20 - Andy’s approach working with Powerlifters
Links and Stuff
Dr. Andy Chen - @dr.andychen
James Cerbie - @jamescerbie