How To Bring Complex Concepts into Your Practice with Dr. Mike DeMille

You're listening to the PT Profit podcast, episode number 97. Today I'm sitting down with physical therapist Mike DeMille, and we're talking all about PRI and how to bring complex concepts into your practice. Are you ready? Let's get started. Hi, I'm Beverly Simpson, former fitness manager turned online personal training business owner. And this podcast is where smart fitness professionals, including trainers and clinicians, discover how to increase client performance and movement, package and position their products and services and get out of their own way so that they can increase their revenue to live a life that they love without sleazy sales. Welcome to the PT Profit Podcast. What's up coach? Thanks so much for pressing play on another episode of the PT Profit Podcast podcast. If this is your first time here, welcome. I'm Beverly Simpson, I'm your host and today I'm sitting down with a physical therapist, Mike DeMille, who is the owner and founder of Divergence Physical Therapy and Wellness center in Wellesley, Massachusetts. And today we're sitting down talking all about pri. What exactly it is, what the difference is between pri, prc, PRT and how we can take some rather complex concepts, simplify it based on the context of the people we're speaking to, whether they're athletes or general population or other trainers and coaches and clinicians and really implementing these high level concepts and putting them into your practice, as well as navigating the nuances between implementing a process that works and standing apart in a market space. So Mike is a postural restoration certified practitioner who treats patients that are dealing with chronic pain. And he helps progress his patients to go back to an active lifestyle of weight training or their other favorite healthy activities. And he shares in this episode his experience from baseball, graduating from Springfield College. And he talks about how he uses his unique skill set and knowledge base to provide corrective exercise in a comprehensive neuromuscular re education capacity for his clients and patients in order to optimize results. So without further ado, let's go ahead and roll that interview. What's up, Mike? Thanks so much for joining me today. How are you doing?

I'm doing good. Thanks for having me. Long busy week, but happy to be here.

I love it. I'm super excited. This is going to be a great episode. So for those of you who have not had the pleasure of working with or speaking to you, I'd love for you to please just introduce yourself, tell us a little bit about who you are, who you serve and how you got there.

Yeah, for sure. So I'm a physical therapist. I work in Wellesley, Massachusetts, and I've recently opened my own clinic. So been practicing physical therapy for about three or four years. I also do a lot of strength, conditioning and personal training. So I was originally a baseball player. I was originally an athlete, and that's how I got introduced to PT in the first place. So it's really funny because I had, like, a quasi arm injury when I was very, very young and then just decided that I wanted to do physical therapy because of that. So there wasn't all that much thought that went into it, but a lot of it had to do with baseball and baseball training and pitching and not getting injured. So that was really my passion when I went to school. And then I ended up going to Springfield College, serendipitously, because that was basically like the level of baseball that I could play at. And they also had a PT program before I went there. I didn't realize that I was going to meet people like Eric Cressy and meet people like Pat Davidson. And that's how I got introduced to pri, which is a huge part of my practice now. So it happened kind of by accident. Like, I knew I wanted to go to school for physical therapy, but I didn't know much about it. I just knew that I like to play baseball. And then the more that I learned, like, when you meet people like Pat Davidson is a good example, you can go deeply down a rabbit hole through all of the experiences that he has. So what started as like a very baseball specific journey has now turned into learning about exercise science and learning about chronic pain and learning about different orthopedic injuries. So that's how we got to the place that we're at now. So I was practicing physical therapy for a few years, and then in this past year, I got the opportunity to open my own clinic. So we've been here for a little while now, and that's where my passion is.

That is so cool. Okay, so I've got a couple of questions because I do want you to expand on pri. We hear. I feel the buzzword a lot right now. So I do want to talk about that. But before we get there, you know, I feel like a lot of people get into what they do because they're doing a whole bunch of me search. Right. So do you feel that this quasi injury of yours was. That's what caused you to, like, get into. Get into pt, like, baseball specific? Like, were you looking at rehab or did you just. Or was it more like, oh, this could be cool? And then you met someone and went, wow, I Want to go way deep on that.

Yeah. So for me, it had a lot to do with injury prevention and also baseball performance. There's a very specific type of athlete, and we see a lot of them who is in New England, they're a Division 3 baseball player. They don't necessarily have all of the talent or all of the skills to take their baseball to the next level, but they're the type of athlete that will do whatever the coach says. They'll dive all the way into the deepest things that they can to affect their own performance because they're trying to get an edge, and you can take those qualities into anything that you do. So, like, for us, you know, in New England, you play baseball for five months out of the year, and then the other seven months are spent in the weight room and training. So even though I was playing baseball, it came a lot more about learning about training. And at the same time, I was taking all of my physical therapy classes. So by the time my baseball career ended, it had nothing to do with myself anymore. And I just really fell in love with the science of biomechanics or the science of breathing or the science of injury prevention, and just became about things that had nothing to do with me. And then that's what started this total separate industry. So, like I would say the. What got me to this place was I was trying to find out absolutely anything and everything I could to make myself the best baseball player possible. And that's, like. That's the lesson that I learned, that if you dig really deep, then you can, you know, really maximize your potential. But now that it has nothing to do with baseball anymore, it's about maximizing my potential as a physical therapist or a business owner to help other people. But the skill of, like. Of knowing that my talent can only take. Can only take me so far. So I have to do these other things to give myself an edge. Has a lot to do with what we do now.

That's amazing. Okay, do you help baseball players now? Are you helping more of, like, the general population?

So we kind of do both. I still have a foot in the baseball world, but we also see the general population as well. So we have two kind of distinct client groups. So when you do pri, and I have the prc, so I do have a slot on their website, and a lot of people will come and travel to our clinic if they're familiar with PRI and if they're seeking out a PRI practitioner. So that's like one very specific client group. And it's interesting because we communicate with them in a specific way because they're looking for pri, they're searching online to try to help themselves and they've already heard about it. That is an incredibly different client group than people that are local, that live like in towns that are next to us, but are just generally in pain and have never heard of PRI before. So when I talk to different physical therapists about this, an issue that you run into is you're trying to explain everything that you know as quickly as possible. And if you're seeing someone who's coming to you for pri, like we even treat some personal trainers. So someone is like on my Instagram page and they know that I do PRI and they've been to courses before, that's going to be an incredibly different conversation than someone who's in Wellesley, in our town, who lives down the street that has heard of any of this before. But they're just in low back pain and they don't want to be in pain anymore. So it must have to. We have to be able to turn it on and turn it off and have a very context specific conversation based on the type of person that we're seeing, keeping in mind where they came from and how they got to us.

I think that's so important because I see often as I look out into the space that so many people want to talk and explain and demonstrate through what they're saying, like, look how smart I am. You need to just do blah, blah, blah, but, but missing that connection component with the person that they're talking to just from a contextual viewpoint. So before we go down that rabbit hole, because I do want to do that, because I know that that is a skill of yours that you're able to do that, can you just give us a little context around PRI specifically and like the differences between PRI and prc? Is that what you said, prc? Can you give us just a little bit of some context around that? And what are the differences between someone who is PRI or isn't? Like, I know there's layers inside of this.

Yeah, for sure. So what the PRC entails. So PRC is postural restoration certified. And if someone is a doctor of physical therapy or I think just a physical therapist in general, and you've taken the primary PRI courses. So the three primary courses which people might have heard of before, it's myokinematic restoration, postural respiration, and then pelvis restoration. If you've taken those three primary courses and you go to the big four day course, which is called advanced integration, which happens at The PRI headquarters in Lincoln, Nebraska. At the end of the year, you've taken those courses and you fill out a PRC application which involves reporting on case studies and reviewing different pieces of literature. You basically fill out. I think the application I filled out was like 40 or 50 pages or something like that. So it's fairly involved. So you do all of that and then you sit for an application at the headquarters in Nebraska. At the end of the year, you go through a little testing process and then if you pass all of that, then you become a PRC. So I want to say there's something like 200 PRCs in the country and there's some in, I think there's some in Japan and there's some in England, but there's only two right now in Massachusetts. So we end up getting a lot of people that are specifically looking for pri. And we just became the second PRI certified facility in Massachusetts. So people can find us that way. So a lot of folks have been to maybe one or two PRI courses. Like you could go to a weekend myokinematic restoration course. But there's a difference between taking one course versus being eligible and then going through the certification process. And once you go through that certification process, then you become kind of an affiliated member and then that's how people can find you on their website.

So now just for my clarification, because I remember I looked into this a long time ago, you can only really, you can only be PRC if you are a physical therapist. Like strength and conditioning coaches can take the classes, but they can't get certified. Correct?

Yeah. So I want to say, so there's two different kinds of certifications. The PRC is the one for physical therapists specifically. And then there's postural restoration trained, which is prt, which is the strength conditioning specialist, the certified personal trainers, athletic trainers, and there might be a few other different disciplines. And then I want to say PRC is also eligible for chiropractors as well. So prc, I would say is more shifted towards the medical practitioners, the clinicians, especially the hands on practitioners. And then PRT is more geared towards the strength conditioning or athletic training folks.

Cool. So now what caused you down this PRI rabbit hole? And what would you say is the PRI difference?

Yeah, so I had a really interesting opportunity because I was in undergrad of physical therapy school just starting to learn about physical therapy itself. And I stumbled upon PRI through my baseball training like I was talking about before. And I became really close with one of the strength conditioning coaches that was at Springfield College. I used to work with him, Sam Sturges. I've talked about him just on my Instagram, and we're really close friends. But I became really close with him, and he had done an internship at Eric Cressy's gym in Massachusetts, which is a baseball training gym. So it was very much like a small world experience where, because I was training for baseball at Springfield, I. I learned about this branch of physical therapy that had nothing to do with the, you know, education that I was getting in school, but I was learning it on the side at the same time that I was pursuing my degree. So it was the type of thing where, like, we would go to our regular physical therapy coursework, and then I would go to, like, this PRI weekend course when I was, you know, 20 years old and playing baseball. So I got to learn both of them at the same time. And the best way I would describe it is if you're an athlete trying to reach their potential, and you're looking for other things that involve thinking differently or things that people probably haven't tried before, or people that are thinking in a different way. That's how I would describe pri. You go to courses, and it takes a while to break into, and it takes a while to understand and a while to master. But once you get past that little point of resistance where the topics might be complex, or a lot of times the topics might conflict with conventional wisdom that you've heard before. Once you break through that, then you can really see the differences in the nuance and have an appreciation for this very different way of looking at physical therapy and human movement and human behavior and all of these different things that can make you a better clinician.

So what are some of the big. You know, we hear a lot about breathing, and we hear a lot about, like, pelvis positioning and rib cage relationship. Right. So, you know, are the. What else would you add to that list in terms of things that they go. That they talk about that are, you know, against conventional wisdom?

Yeah, sure. So if you were to go to a conventional physical therapy program or any exercise program, all of the exercises or all of the stretches or all the modalities that you would do require movement that would be the same on the left side of the body as the right side of the body. And one of the foundational principles of PRI is that we have a left diaphragm, which is our breathing muscle that's different than the right diaphragm. So because of that, all of the muscles that are on the left side of your body are going to work Slightly differently than the muscles that are on the right side of your body. If you haven't heard about these concepts before, a place where people often get stuck, especially in the beginning, is, is does this apply to people that are right handed and people that are also left handed? And the answer is, even if you're left handed, you're going to have this left diaphragm that's in more of an inhaled state and a right diaphragm that's more in an exhaled state. So that's kind of the basis of where the asymmetry comes from. And then there's a lot of deep levels where all this asymmetry exists. So in our stomach and our guts and a lot of our internal organs, our, all the way up to our brain function. So if you've heard of right brained people and left brained people, this asymmetry permeates all of the systems of our body and that is a big basis for pri. So if you have someone that has this asymmetry acting on them and you're unable to balance it, so everyone is supposed to be asymmetrical, but a lot of people are not fully balanced. So that would be someone who's overly right sided, dominant, that might have some injuries that go along with that. So to sum up, if you're to think about pri, you're using the natural asymmetry that exists in your body and you're trying to work with it in a way that keeps you balanced so that you avoid pain and that you avoid injury.

Okay, well, I've never heard it explained like that. That's pretty fascinating. That is, that is fascinating. But also, you know, I, I do want to, and I did allude to this earlier, is that you do have the skill in being able to take these like really complex, these really complex concepts and simplify it. Because I feel anyone who has, and I'm laughing because I will never forget the first time like I went onto the site, I was like, this is English, you know, so a lot of people will have that, that experience first off. So I do want to talk a little bit about how you, you know, because I know you work with other clinicians and you also work with athletes and you work with gen pop. So how do you navigate meeting where they're meeting the, the client where they're at? How do you navigate bringing these higher, high level concepts in and implementing it to, you know, your general population?

Yeah, so the trickiest part with that is you have to take all the information that I just talked about, and then you have to be able to relate it to the specific concept of the person that is walking in. And the thing that I really like about PRI is that a lot of the mechanics can relate to everyone. So if you take what I just talked about and you're saying that you're trying to use the body's natural asymmetry to create balance, there isn't a single person that I can think of who that wouldn't apply to. But if you're dealing with a specific person, you have to explain it to them in a way that's going to make sense to them. So let's say we're talking about a baseball player, for example. If I do a bunch of different testing and I show them that one side of their body moves differently than the other side of their body, and they can see and they can feel that, then we perform a few different exercises and do interventions where now both sides are moving more in synchrony and in harmony, then that's going to make a lot of sense to them. Another easy explanation that works a lot for people is you need to be able to rotate your upper body in the opposite direction that you rotate your lower body. So I have, like, this twisting and untwisting that goes on, and that keeps all of my muscles flowing the way that they naturally should. So a lot of people that have never seen me before, I'll explain that to them and show them how that relates to walking and every single step that we take. And the biggest thing that you could do in that context is show them how they look and feel before the exercises that you do and after the exercises that you do. And if they can see and feel the difference of how they showed up in your clinic or your gym or whatever versus how you left without getting into the details of. I won't even say the word diaphragm or like, I won't use specific muscle names or I won't use, like, any specific verbiage that we would like if we were sitting down and taking a course. And that seems to really resonate and connect with people. So you have to take all the science that you know, and it is good to know a lot of science, but you have to translate it in a way that relates to very specifically to what the person is coming in with and who they are and what their activities are, and you have to be able to relate it specifically to that.

So now do you think that your athletes that you work with, do they tend to fall more into, like, wanting to Know more science or are they still more like gen pop type of people? Like I don't care what the science is.

Yeah, it's interesting. And that relates back to what we talked about before, where we have these two distinct groups of clients of people that specifically have heard about PRI before that come in and they're very much looking for information related to pri and they'll ask about it and they'll ask specifically about, you know, a PRI test that might have to do with their body or they're coming in with like pre framed information and pre framed expectations versus if it's someone who's local and has never heard of PRI and sometimes hasn't even heard of me before, but they might have been referred over by a surgeon or by a doctor. I might do exercises and techniques that I know will help them, but I might never say the words PRI because truthfully, it's not important to me that they know exactly what I'm doing and why I'm doing it. In that case, it's very important to me that they feel better when they leave compared to when they came in. And then as the weeks go on, especially if I'm doing exercises that might have a balloon or might have their feet on the wall, or might look very differently from what they've done before, but they know that it's effective and they know that it's working. After four or five sessions, I have some patients that might try to ask more questions just because they're curious, because they're getting a very different experience than what they've gotten for. And in that case they're basically giving me permission to go a little deeper. But I would say a good rule of thumb is if someone is not asking for that, then only stick to what you think is going to help them the most.

So I do want to actually go into this results conversation because one of the things that I heard you say a couple of times is that people will come in and after one session already notice and feel a remarkable or a difference, remarkable, but a big difference in how they came in versus how they came out. And so I think it's a nuanced conversation between the definition of insanity, doing the same thing over and over and expecting a different result, but as well as just trusting the process. No one's going to deadlift 400 pounds, you know, rip up 400 pounds after they learn how to deadlift for the first time. So how does, how do you navigate the outcomes in that way?

Yeah. So what is coming up in our clinic? A lot right now, and this came up in the last round of Solidify that we just finished, is the specific methods of a treatment approach that has to do with a test, intervention and retest model works very well specifically with cash or out of network physical therapy versus in network physical therapy. So for people that don't know, if I were to go to the traditional in network physical therapist, I might see a physical therapist for 10 or 20 minutes during a session and then I might work in a large gym area or work with an exercise tech or work with a PT aide and do a program that was written that does not have a lot of coaching or queuing that goes along with it. Now if you were to do that with PRI specific exercises that only work well with a lot of cueing or a lot of coaching or a lot of one on one attention by the therapist, they're not going to have good results unless they're seeing someone one on one, a skilled clinician, one on one for an entire hour. So a big difference there has to do with our specific business model. So a lot of people that practice PRI and people that are PRI clinicians do happen to be these cash based or these out of network providers. Because a lot of the clients that get to me have been to the conventional physical therapy model before and they have not gotten the attention that they've needed. And that's why they're still dealing with whatever issue they came in with. And that's why they're looking for more answers beyond what's normally offered to them. That's why they're seeking something that's a little different than what they would normally get prescribed.

So how long do you and I know that this is going to vary? So just, you know, take the, take this question with a grain of salt. But typically for your patients, how long does it take for them to see a result or an outcome that. A desired outcome.

Yeah. So we have a few different packages and a few different treatment models that we use with people. And I have a graphic that I usually use to explain this. But when someone comes into our clinic or anyone's clinic, it's because they're having pain and it's because their body's not in a state of homeostasis or rest. So the first thing that you have to do is get them from a painful state back to being in no pain and being at rest. And based on regular healing times of the body, that can take anywhere from four to six weeks. If it's a chronic issue, maybe a little bit more. But in just about a month we have. And that's, you know, generally speaking, not specific to a person. We have a good idea if they're getting back to homeostasis. Now, homeostasis is very different than allostasis, where I'm trying to take someone and make it more difficult for them to become injured again. So that is where a lot of strength conditioning and a lot of specific, like exercise training with the biomechanical PRI principles that we've done with them for the first four to six weeks to get them out of pain. That's where a lot of allostasis exercise training applies. And really, the stronger someone gets, the less likely they're going to get injured. So we'll see people for an infinite period of time, starting with them getting out of pain and not being injured anymore, but then ending with as much prevention as they can possibly use to get as far away from re injury as they would like to get.

Okay, I have a couple of things to say, but first, just to wrap this up, so four to six weeks, that's amazing. I hadn't, I mean, and I know that that's arbitrary and that it's, it's, it's a range and that that's going to happen, but I feel like so many people are dealing with chronic pain all the time, and we are told to deal with these like, or we'll get these moments of temporary relief not realizing that it's not having a compound effect. Like we'll have a temporary relief for like three minutes or, or, you know, an evening and. But it's not getting better. But it's like, it's almost like we're tricked into thinking that it's getting better.

Yeah, I'd say, generally speaking, accepting the narrative that we are supposed to live with pain is definitely not helpful to anyone. And you know, the thing I like about PRI specifically and the interventions that we do is you'll know that you're at least making progress if not having no pain after an exercise or two, because you're testing information before you're looking at information after you're very specifically affecting the nervous system itself, trying to give it new information. So after an exercise or two, you might not be totally cured, but usually your body will feel very different. And that is a different experience than doing an exercise just for the purpose of doing an exercise and basically letting time and strength do the work. It's a very different and specific effect.

Okay, so now I'm curious about, because this is something that I feel like comes up a Lot. At least back when in the day. Back in the day, three years ago, when I was training in the gym floor, is that you would see these people that'd be like, oh, we're doing our corrective exercises. And then they'd spend, like, 45 minutes of their time, like, rolling around and, like, doing corrective exercises when the client came to work out. Right. So how are you navigating, especially in that rehab experience, as you're moving them towards more strength and conditioning programming, how are you navigating like this is rehab work, but also letting them feel and their body feel like they've got time under tension, under their belt?

Yeah, it's a really good question because it happens a lot in you and I have talked about, in different contexts, the difference between the four stages of competency. So unconscious competency, conscious competency, et cetera, et cetera, with the goal of getting to unconscious competency, meaning you're doing things correctly and you don't have to think about it. And from a PRI and biomechanics and training perspective, when people get there, I'll barely have them warm up anymore. They're coming in and they're training right away because the changes that we're trying to make in their body are completely sticking, and they don't have to worry about that anymore. So at the same time that we're trying to get people out of pain, we're also trying to change a fragility mindset of thinking that you need to warm up for 45 minutes and, you know, work out for five minutes, and that's what you do that day. You know, at the same time, like, those things can also shift. So what I don't want people to do is think that they're very asymmetrical or broken or that these things that we identify are bad things. They're all natural, and bodies are meant to be strong, and bodies are meant to function well. And we really want people to feel that when they come in.

I love that you're talking about the fragile mindset, though, and I don't blame people for feeling that way. When you've been in chronic pain for a long time, of course you feel fragile, you're broken. Like some things that you can, you know, like you're fragile. There isn't a better word for it. So I'm curious, too, you know, when you're working, because I know that you're running a facility now, and I know that you particularly work with people in pain, at least to start. But do you bring this work to people who have. Maybe they're not in pain, but they're not moving well. Oh, it.

Yeah. So a good thing about what is happening with a lot of physical therapy now, and it certainly happens in Massachusetts, is our patients have direct access to physical therapy. So maybe like 10 or 20 years ago, you would have to have a conversation with your doctor and say, hey, I'm having this ankle issue. Can you write me a script to go to physical therapy? But nowadays you can choose to go to physical therapy on your own, and if you're paying cash, you can do whatever you want. So we have more and more people, and I think this is a very good and healthy trend that are going to physical therapy before they have an injury, not afterwards. And even though you might be putting in more of a time investment and a money investment and an effort investment upfront, you're a lot less likely to have more issues in the future. You know, it'd be no different than like having a BMI screen tell you that you might be in an at risk range or having your blood pressure be slightly elevated and getting on a medication before you have a cardiovascular event. You can do the same exact thing with biomechanics or range of motion. You can identify a potential risk factor, get treatment for it, and then solve an issue before it ever happens. And I think especially these physical therapy clinics that have a lot more exercise embedded in them, we're seeing more and more people seeking that out, which I think is fantastic.

Well, I'll share too, that even hearing you say that, I don't think that that's messaging. That is what that is common. Now, if you're listening to this podcast, like, yeah, I hear this all the time. Well, you're looking at it in a narrow context. Yeah, sure, maybe your thousand Instagram friends that you have are all talking about the same thing. But if you want to go look and see what people are thinking about, go to Pinterest, go to TikTok and type in physical therapy, and your mind is going to be blown about what the average human being is consuming when they're thinking about physical therapy. Because for me, I had not the idea or thought of going to a PT before injury has not even crossed my mind.

Yeah, I'm certainly in a bubble, so I probably think it's more common. But that's because all of the people that I talk to, and the truth is like, compared to the general population, your listeners probably notice that as well. But the average person that might live down the street from our clinic has never thought of it that way. And people have a previous idea in a frame of what physical therapy is about what their bodies are capable of, about how they're supposed to feel, and how all of these things go together. And it really impacts the way that you have to communicate with people. And so the general public, for sure, but also different medical practitioners that might be the resource that is getting us, our clients, so physicians or surgeons or chiropractors or anyone else that is on that continuum. A lot of times it's having conversations with them and changing their minds about what physical therapy is too.

Yeah, absolutely. I mean, I hadn't even thought of that because, I mean, I had a girlfriend once and I. She was pregnant and I referred her to a physical therapy, pelvic floor physical therapist because she was having some pain and the PT turned her away and said, no, no, we don't see you until after you've given birth. And I was like, what?

Yeah.

Really? Right. So that's another thing too to remember, especially if you're listening, is that your messaging and what your voice and what you're here to do is just so important, even if you think everyone else is speaking it, because they're just not. They're not.

Yeah. That is like, very metaphorical to a lot of things that can plague our industry in different industries, like if you're going to be a very good physical therapist or if you're going to be a really good strength coach, it's more than likely that there are a handful of specific things that you're very good at that might not feel exciting anymore. But if you do them again and again and again, even though it's not new to you as the clinician, it's very new to the client or the patient that you're seeing for the first time. So, like, if it's, you know, one of the first PRI exercises that people will get is a 90, 90 hip lift, so a feet on the wall, you know, turning on your hamstrings exercise. And I might give that to eight people in one day and I might explain it for 25 minutes each time. And to me, it's very monotonous and I do it all the time and it's boring. But each new person that I see where it's entirely brand new for them, they're really going to have an experience while they do that. And a lot of the pts that are successful appreciate and understand that they have to do the same thing over and over and over again to have this big effect on the population that they're seeing. And the physical therapists that don't do well tend to try to seek things that are incredibly new and incredibly novel and be overly cutting edge when the reality is that's not what their clients are asking.

Yes, I know. That is so true. And I love. Like, that's a really good segue into, like, some of the work that you're doing in Solidify. Because I feel like what happens is that. And it's no one's fault. Right? It's our brain. We're designed to automate things we want and the. Those monotonous movements that we do all the time. We think it's boring, but it's going to be transformative for our clients. We tend to undervalue that impact. So then we start to reinvent biomechanics. No one said that you need to do that. You just need to reiterate the basics and do the basics really well.

Right.

So I'd love for you to, like, expand a little bit on. I feel like that concept was part of what really birthed that Solidify. So can you talk a little bit about, like, your mission and how you're helping clinicians, like, take their information and actually implement?

Yeah, so. So my first ideas for Solidify probably started at. Towards the beginning of the pandemic, like, that spring. And the first thing I said was, I am not going to be one of these people that makes another online course that you can sign up for, because every pt, their patients can't come in anymore. So they say, you know what? I'm not a physical therapist anymore. I'm, like an influencer, educator. And I said, no matter what I do, I'm not going to turn into one of those. Because, like, it seems really fake. It seems like it came out of nowhere. It seems like it's, like, to make a quick buck. And for six months, I was steadfast in the idea of, like, I'm not going to turn into one of these people. But what I started to realize and what I started to notice is I really felt compelled to be a voice of reason and an advocate specifically for pri, because on Instagram or social media or wherever you go now, you'll see a bunch of people taking PRI concepts and turning it into their own model or taking a flavor of pri, but then really doing what they're trying to do and then packaging it off as its own thing. And what I wanted to do was create a course that stuck really true to what I knew worked in the clinic. So it seems like a lot of clinicians nowadays are trying to seek something that they think is brand new that other clinicians have never seen before so that they can be smarter than other clinicians that they know. But just like we talked about before, being a very good clinician and a very good educator and sounding smart to your friends basically is an incredibly different proposition than seeing local clients in your area that don't necessarily care what your level of knowledge is, but are looking for results and looking to get out of pain. So I wanted to create a course that stayed true to a lot of the techniques that I've used that I knew were simple, but I knew could get people better. And I wanted to take all of the noise that exists and really consolidate it into one small, easy to learn, easy to use, practical course that I knew people could start to do right away. Because a lot of the feedback that I would get and a lot of the questions that I would get was, you know, I'm learning about this piece of information over here, but then this person is saying it completely differently. And then I always thought it worked like this. And I don't know if I should take more PRI courses or I don't know if I should take more of these courses or I don't know if I should start to learn this brand new thing. And the noise has really crippled a lot of clinicians. And at the end of the day, I wanted to be able to explain the techniques and principles that I didn't think were necessarily complicated or difficult to learn, but the ones that I knew would be really successful for people, specifically trying to impact as many in person clients and patients as possible.

So what you said is something that is just so profound and I feel like it's really important because what I deal with a lot is people coming up to me telling me, and it's something I've personally battled is feeling like I don't provide enough value. It's not enough value to do that. Right. Like I'm just not really doing anything. But I think people don't realize the importance of clarity. And then when we're inundated with information, people get into analysis by paralysis. So and so said this, so and so said that. So and so said this. And we're also in this age where, you know, people are trying to rehab their pain from their Instagram pt. And that is not a knock on Instagram. Like, listen, I built my life, my business on Instagram. That is not a knock on social media. It. It's just something that we need to be aware of. In terms of perspective so that we can really meet people where they're at and then carry them along for the ride. Because you people get inundated with information and then don't take action. And it just gets worse.

There's a huge difference. Cause I just had a friend of mine here who's a PT and also prc. There's a huge difference between having a conversation of what's the difference between an inferior capsule stretch and a posterior capsule stretch and proximal hamstring tension and blah blah, blah. Like I would call that trying to write a story with a very thin pencil with a very thin line versus when I'm talking to a patient, I want them to see very bold, thick, easy to understand lines. And I would just tell them to feel their hamstrings. And I'm not getting into specific details. Now if I as the clinician know the specific details, I'll be able to help that person a lot more. So improving your knowledge base and having a thorough understanding of anatomy and taking multiple courses as a clinician is incredibly important. But being able to take all that information and giving your in person clients very big, bold, easy to understand and easy to see lines is what separates the people that are really successful from the people that are still trying to be successful.

So good. So now you know, one of the things too that you've talked about is, is that concept of implementation. Essentially when Pete, I feel like in the olden days, olden days, 2015. So what is that six years ago, right. There was never a practical component to your education. It was like reading a book. And then now you're sort of, or you're reading a book and you're going to go get tested. Right. To me that's this. That's like trying to swim by reading a book. You can't. You have to get in the water to learn. Right. Is there a practical component to pri in learning it? Or is that where, or is that like where you just have to go in and get your hands dirty and do some clinical hours?

Well, that's where specific in person experiences make a big difference too. And that's another one of the reasons why I created Solidify. Because there's a big difference between being in a room with 30 people and having one instructor and getting a lot of information but not really having a chance to do it versus what we do, which is like five to six people. That's 10 hours of one on one education. And one of the things that I like to do with the people that do Solidify is to have one on one calls with them that they can schedule whenever they want so that it's me and them talking about their patient based on the concepts that they're learning. Because the people that do the best, and what I try to do at my PT clinic divergence too, is we'll go out and take a course, but then we'll talk about how the course applies to our patients and we can see them in there in front of us. And another thing that PRI just did that's really good is they just made a mini residency program which is similar to like a physician doing a residency is you can go to a clinic for six weeks and see all of this practical application of these concepts that we learn in a big course. The truth is, the course alone, without the practical application is not going to be all that helpful. And then the other reality is, and this is a lot of the people that signed up for the first round of Solidify, not everybody has a clinic that they work in with five or six clinicians that think the same way that are taking the same courses and trying to apply it in the same way. So the people that feel like they're kind of on an island and their only option would be to either take more PRI courses, specifically try to learn from other people on the Internet, or just like go it alone and see how well they do, that's the people that Solidify is for. So, like in the last round, we had one person from Australia who was the only person in his clinic that was really doing PRI and he was getting stuck because he didn't have anyone to bounce ideas off of. We had someone from Slovenia who was a very similar scenario because, you know, I'm lucky in Massachusetts, where I could go down the street, you know, and there's another PRC and I can reach out to my friends and we can get together, but we saw a lot of people that are in very kind of isolated environments where taking another course and getting a big dose of information would not have been more helpful because they haven't sifted through the original information that they got. And the PRI courses are designed to give you so much information that you have to slow down and take your time and learn it on your own. But if you feel like you're on an island doing that, you need a group and a cohort to learn it, to learn it with.

I just think community is so important. I will always. Coaching and community, just, just no matter how smart you are, having someone to talk about an experience, interesting, introverted or Extroverted to just kind of process through what you're learning and what's happening and what kind of results, I just think it's just really important to have. For me personally, I will always be surrounded by people going through the same thing. I think it's really important.

But more people you have that are together that have gone through different periods of trial and error. If you learn from someone that has already made the mistakes, then you're not going to make the mistakes on your own. And if you're in a group that's really open to talking about that, because I've made tons of mistakes. Everyone that practices PRI and physical therapy has made tons of mistakes. When you can openly talk about those in a non threatening place where you're not trying to argue, you know, which branch of continuing education is the best and you're only trying to talk about having the best results for your clients and that's what the argument is. That's when you really grow.

Yeah, I feel like a lot of people and I've battled this myself, is that. And I, I often check in and ask myself am I trying to be right or am I trying to get results? You know, and I think it's a really powerful question to ask yourself because trying to be right and trying to argue for the sake of arguing, it comes from an ego perspective and it's not coming from a place of like how can I be of service to this person or to my people right now? You know, so. And it's hard to do that. It's hard to do that. Especially when you get to a certain level, like anyone who's taking PRI, like you're someone who is in the top 1% of people. Right. In terms of strength and conditioning, the level of the barrier of entry, it's fairly low.

Yeah. And I hate if I was out on social media and I was trying to argue to someone that PRI was better than what they were learning. None of my clients backs would feel better if I won that argument. None of my clients will feel better even if I win that argument and people think that PRI is the greatest thing in the world and that I'm the greatest person in the world, like that doesn't help anybody improve their results. So if the goal is to help one's clients and it has nothing to do with being deemed the smartest person on the Internet, then they can probably make a lot of progress and results.

Yeah. So good. So good. But I am curious to hear your thoughts and if Solidify does, does talk about it at all is the idea of creating your own, you know, taking what you learn and, and not reinventing the wheel, but, but creating your own model and creating your own experience. Like your thoughts on that?

Yeah. The truth is there's so much that we can individually experiment with and try that. At a certain point you have to start trying something and learn how well it works with the people that you're seeing, learn how comfortable you are with the techniques, learn how good your cues are with it. And once you start to try, you know, a certain set of exercises or a communication style, or a certain group of tests, there's so many options out there that you'll quickly find out what works well for you and it might be different than what works well for someone else, and that's totally fine. But when you have a large framework to work from, you know that you're not shooting in the dark and you know that your guesses are coming from an educated place. And then at that point, you know, if it has an evidence base behind it, you can get incredibly anecdotal in the clinic if you'd like. Because if your clients are getting better, they're not going to ask you if your exercises are substantiated by a bunch of randomized control trials. They'll just feel really happy that they got better. So you definitely have to practice in a way that's very evidence based. But if you're doing that, you can then really do what starts to work for you. And that might be very different than what works for me, and it might be very different than what works for someone else. But in Solidify, we're trying to give people as many options as possible and have an understanding of a bunch of different options so that they feel more confident trying things on their own and that they'll be more successful with. If I learned a nine step PRI exercise and I saw, you know, somebody in a course teach it once and I was too afraid to ask a question. I'm very unlikely to try that exercise in my clinic on Monday. But if I've had a 45 minute conversation about it and then had a one hour follow up call on it, and then I was accountable because I knew, you know, someone was going to ask me if I tried it the next week, I'm going to try it. So you don't have to have the, you know, the whole myokinematic course completely down, but you might have to have one specific exercise really down, and you might have to force yourself to take the chance to try it and then if you have a group in a community that you can bounce your ideas back off on of what went well and what didn't went well, then it's going to be more likely to stick.

And I also think it's a great point to end on in the sense that there is a difference between a skill acquisition and mastery. A level of mastery you have to. No one learns how like, oh, okay, I rode a bike, I'm going to get on the bike and never fall down. Like people fall down. They have to learn how to master their balance before they can be doing these. These like tricks and wheelies and whatnot. Right. Like mass with mastery. It's not just about the skill acquisition. You have to put the reps in.

Right. And it's a perfect place to sum all of that up. Which is just like our clients need a place to experiment and feel new things in their bodies and try different things and try things that they're afraid of. Clinicians need a space to do that same exact thing. This is the only way that we grow and get better.

It's true. Okay, so for those of you who want to learn more about you, where can I send them?

Yes. So go to my Instagram page, Mike DeMille, DPT go to my clinic's Instagram page, Divergencept and Wellness. You can go to our clinic's website, divergencept and wellness.com, where you'll see our physical therapy clinic. But then you'll also see a solidified tab where you can learn more about the program. So applications are going to be open in the middle of September, so keep an eye out for that if you're interested. And that program is probably going to start the first week of October and it'll be a 10 week program.

So cool, so exciting. And of course, we'll link all that up in the show notes. So thanks so much for your time today. I really appreciate it. This was so helpful.

Of course. Thank you so much for having me. It was a blast.

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