262- Getting Started with Sports Chiropractic w. Dr. Rick Rosa

Welcome to the Evidence Based Chiropractor where each week we deliver the latest chiropractic research and marketing strategies all in the time it takes to get to your office. Now here's your host, Dr. Jeff Langmaid.

Hello and welcome to the Evidence Based Chiropractor. I am your host, Dr. Jeff Langmaid. If you are interested in sports chiropractic, this episode is for you. You probably have heard me talk about, I believe sports chiropractic and sports related chiropractic is one of the most high growth segments within the chiropractic industry and I had the chance to sit down and have a really, really cool and interesting conversation with Dr. Rick Rosa. Rick has an incredible clinic and practice system. Multiple runs, over a dozen and continuing to grow. He's taken care of some unbelievable elite athletes. I'm a boxing fanatic. And he's taken care of Amir Khan amongst a host of other title holders and he has some really interesting insights into sports chiropractic. He has been doing it since the beginning, since there probably was no such thing as sports chiropractic. And he's still a young guy but he has a ton of experience in this realm and we have a super interesting conversation all around sports chiropractic that you're going to want to stick around for. Before we get started I will ask you to check out SHIELD if you are looking to get factory direct pricing for your braces, tens units, stem units and more check out shield@super secretsales.com ebc A couple of weeks ago I had their founder Dr. Steven Brown on here and he is offering a complimentary Shield 10 S E stim unit plus free shipping on your first order. Fast shipping, factory direct pricing and a great selection of products are available right now@supersecretsales.com EBC without further ado, here's my conversation with Dr. Rick Rosa.

But in the I finished in the late 90s, 19, graduated 1996 and in the early 2000s, late 90s, you know, if you wanted to do anything from a marketing standpoint, it still, you know, it was all about branding which is still obviously very important. So for the sports side I had developed, once I developed the whole recovery concept I was trying to focus on that and I tried to, you know, I branded the name Recovery Doc and I thought it was very clever and you know, and I had a logo made up. But in the end what I figured out was it was more about who about me on a personal level, you know, one on one with the athletes and That I probably. Because then it's hard to brand your regular clinics. Like how do you differentiate that? And if you have one clinic it's not a big deal. But if you're really trying to do reach out, you know, globally to athletes, let's say and lect be on the lecture circuit and write and you know, you're better off branding your name. So that would be the one thing I'd recommend to young chiropractors that are trying to do this sort of thing. You definitely want to brand your name. And also as chiropractors we love just name all our clinics. Right. You know, but we're the only ones that do that for the most part, you know, a lot. Most of the MDs, they might, they're branding more now, but those are like these massive groups that are doing it, but when they're small they're just practicing under their own name. So I think it's important to do both. So that's why I'm taking down the Recovery Doc website and branding my name because then I can brand everything I do, not just my sports stuff, the clinics, the cream, whatever business stuff that I might be doing that's related to healthcare now that it's expanded beyond that.

So I think that's a super good tip. And if I peel it back, even before you get there, you had to start somewhere. So how'd you get it? How'd you even get interested in sports care to begin with? And then I'd love to kind of go through the road of how you.

Get, you know, how do you get.

Your first well known person kind of thing and all that. How'd you even get started with all of it?

Okay. So I think it's important. So I started like a lot of the Cairos that are into, I was always into sports. I was a high school athlete. I probably could have ran Division 3 in high school maybe, but there was no way I was going to suffer, you know, to just run. So that wasn't an option for me. So I was done after high school. And I was always interested in like lots of different sports, not just the classic American sports, football, baseball, basketball, hockey, you know, I liked other stuff, Olympics title sports because I came from track and field. We're Italian American, so I also like Formula one and race car driving and all that kind of stuff too. So I'm just into all performance, you know, I just always been interested in that. So in chiropractic school we had the sports Injury club which then morphed into the sports Performance club. And it was just back then, in the 90s, it was just a bunch of different chiros, and we had, like, maybe one person in your class was an athletic trainer before they went to chiropractic school. Most everyone. All the other people were like, biology majors or chemistry majors. It's very different now when I go back to NYCC and you have a lot of kids that are athletic trainers, exercise science majors, kinesiology majors, which is really cool. So, you know, I was always interested in it, but I was never the kind of guy that said, I'm going to build a sports injury practice. I think I was realistic enough to know it's hard enough to start a practice and be successful then than to start out saying, you're gonna be, you know, the sports injury guy. So. But I was always interested in it, and I kept it there, you know, in the back of my mind on day, very, very early. So the way it all started for me was I had a boxer walk into the clinic, and he had an injury. Just a local boxer club level. No one. No one really that important. Um, and I took good care of him, and he told his promoter about me, and there was no one really around. And then I met with the promoter, and I was really young, and they were, you know, I started to treat like everyone under that local promoter's banner. And it was really exciting because, you know, I would go to the fights and stuff, and then they said, hey, can you be a cut man? So I'm like, well, I see these guys. I was like, it doesn't look that difficult. I'm pretty sure I could figure this out. Of course, there's nothing public, really published or articles. And it's just trying to get it out of the old guys that were doing the cut work was, like, next to impossible. You know, they wouldn't give up their secrets. But once I figured out, I mean, it really, you're legally only allowed to use certain things in each state to coagulate the blood and control swelling. And it's not rocket science, you know, and you only have a little bit of time. So I started to do that for them, for their fighters, which was very exciting. So I was in the corner of a lot of these fights, and then you just meet a lot of people when you're in the. In the loop. And, you know, I was always interested, obviously, in new techniques, and just like everyone is, and I was adding them to my arsenal, my toolbox. And I was always interested in martial arts as a kid. And so it was A natural thing. And. Yeah, so that's kind of what gave me a foundation. And then, you know, eventually you get a world champion walks in your clinic, and, you know, that's just what happened. And then in the D.C. area, you know, I got to be really well known as a chiropractor, then just as a. As the doctor. And then I would do a lot of free stuff for, you know, a lot of the gyms. So everyone knew if they had a boxer. Look, this is not, you know, they're professional boxers, but, you know, most of these guys are not making any money. Right? You know, same thing with UFC fighters. You see guys in the ufc, you think they're making money. They're not making money. You know, not all. A lot of them are not making, you know, anything spectacular. Some are making a lot of money, but boxing is even worse. The disparity where you have the world champions, the top tens, making lot more money. So seeing that, I was like, look, come to the clinic. I'll do what I can. At least I'll point you in the right direction. And because of that, I would get everything. Like I was getting stuff that did not belong in my office all the time, you know, which was cool because I can at least get to examine and get to experience it and orchestrate stuff. And being a team doctor and boxing, which is what I essentially was, got me. You know, I very. At a really early age, I had to learn how to tell a doctor, you know, an athlete that you're. You're finished with your career. You know, I just. Thinking of one of the guys who had a brain malformation that the csf, if he would have gotten swelling, would have died. So I had. I was the one who had to order the MRI pre fight. Got it, got that. Talked to radiologist, and then, you know, have to retire them. You know, a guy who, you know, his orbital bones were fractured into, and it affected his vision. So you're collaborating with these other, you know, when you're trying to make deals for some of these, look, this guy's got no money. What can you do for me? You know, that kind of stuff. I was really involved, but that goes a long way. And the community that you're serving, and then, you know, once you made it pro and you could afford me, then you're gonna get charged, you know, and that. That's another piece that you have to learn as a young, you can only do so much free stuff. You know, how do you.

And how do you. How do you balance that? I Know, I'm a boxing fanatic and I see sometimes even the fights, like on Showtime, they'll do the published purses and somebody that's on Showtime as like an opening bout. Some of these guys sometimes are 10,000 bucks, that's six weeks at camp, that's 15% to a promoter that, you know, they're making, taking home 2,000 bucks maybe, and they're like on Showtime. But how do you balance out the free versus the paid? How did you do? Were you like, let me do as much comped as possible because that's gonna come back on the back end. Did you monitor that? I know there's always those questions for the younger docs of how much of that should I do? What's been your experience?

I think, you know, that is like the golden question, right? That really is. I mean, I probably get asked that the most and I would tell people that if there's no magic answer to that question. And you know, I, early on, because of the business growth, had the liberty of spending more time and giving more free to the early athletes I was working on. But you know, a lot of them had health insurance because a lot of these guys are working on top of it, you know, so they would. At least you're covering them through the health insurance. The problem is the non classic chiropractic stuff that I started to do early on, which is all the recovery stuff is time consuming. You know, you're monitoring your, you know, this stuff. You know, I was doing a lot of functional movement screening before that was a thing, you know, and I'm using video motion analysis with it because I didn't understand how you can do a, you know, single legs, double leg squat. And I had an, you know, an instructor going, look, see, it's moving medially. And I'm like, not, not really. I don't really see that. And I've been doing this for 15, you know, 10 years or whatever it was. So I also then trained on using dart fish, which is biomechanical program. Back then you couldn't even get training. So I actually got certified to do bike fits at Serratus Cycling Institute. So I can learn how to use the program and do bike fits because I was also. That was the second piece that added on. Okay, so back to the original question. So it's really tough. You know, you want to do some free and you got to kind of. It takes time to gauge that when, when they need to start being charged something and you need to charge something. I mean, I famously, you know, like I would never work for a professional team ever for free. I mean, well, right now I would never work for pro team, period. I'm done with that. I would. Wouldn't want to do that. Sounds great. It's a lot more work and they don't like to give you a ton of money. And I know guys that are doing it for free. Free. I'm like, you're insane. Like, what do you. And then they wonder why they're not really that, you know, engaged. You know, they're just cracking backs and, you know, in and out, and there's a certain value that you have to have. So if they can. My thing is, if you can afford it, you're paying me, so. Pro athletes, I don't do that shit. I mean, I don't do that for free. Sorry. I don't do that for free. Okay. You know, and I never really did because I did have a problem with you making a million dollars, half a million dollars, $10 million a year. And you don't want to pay me. Like, this isn't. Especially now. Like, I'm not, you know, I'm not Magic Spoon cereal. You know, I'm not just gonna. You can't just send me product and then, you know, I don't. I'm not in that space. I'm. I'm worth it. And if you, if you want that expertise, you're gonna have to pay. You know, I think people won't. Critically, important, critical thing that you need to transition to that. Now balancing that out is difficult and you have to transition. So in the beginning, you're doing a lot more free stuff for athletes, and then you transition out as far as pro level stuff. And pro athletes that are coming in, most of them aren't going to do, you know, most of them aren't coming into your clinic anyway, you know, on a global perspective. But you'd be surprised once you're in. And a lot of it's word of mouth. You know, most of my, my referrals aren't because I had some magic marketing thing on YouTube or Instagram or whatever, because there was nothing like that back then. And I don't really even have a good following. But what I have is a network of people that I've worked with over the past, you know, 20 years that I did good work, I took care of the people around me. You know, that's another thing. You know, don't just worry about yourself. You got to take care of the. Everyone else on the team. You know, there's other staff Other people, these are the people that have potential to refer you business, take care of everyone. And I did that. And I also, I think another thing is people love and I still see this all the time. You know, you get a new technique or a new, you know, especially like with functional movement right now, everyone's got their own system and people just love like bashing everybody's system and their profession or, you know, so if you're part of a team in a group and you don't agree with it, you know, you don't necessarily have to hammer that in. Like, people's got to stop trying to be right all the time about everything. It's not that, you know, it doesn't work like that. Trust me, when you're in a group setting, you got to work with who you're working with. And even if you think you're, they're fine with you, as soon as you leave, they're talking about you behind your back. Athletic trainers, orthopedic surgeons, PTs and medical doctors. You got to know your stuff and you know, you can't be, you have to slide in gradually into what they're doing and appreciate what they're doing, you know, and let them do their thing. You know, don't try to step on their toes because they will, you know, they'll either bark at you or they'll never, you'll never get another referral.

Yeah, I think that's great. I think that's great advice. And when you think about recovery, a place I'd love to go is what are some of your favorite. You mentioned an assessment that, that you're super interested in, but what were some of your favorite recovery tools or strategies or products? What, what do you look for? What have you found to be like those can't, you know, I need this to be able to get in and do my, do my thing right.

So if you look at recovery from an injury standpoint, of course, I'm a chiropractor. We're chiropractors. I think chiropractic is the best recovery tool and all the soft tissue types of strategies that we have, I think you got to be open minded. And if you're doing Graston or ConnectX, the NYCC tool, if you're doing that and it's not working, you know, there's, there's a lot of strategies and techniques that you can learn from and try and I think that's what I might do differently is I'm not, you know, and I'm not just like all about One thing I'm not all about, you know, whatever that name technique is. So I'm trying not to get myself in trouble. But I did all the taping classes and you know, like Rock Tape had sponsored my classes early on before they on my recovery. So, you know, I think I really don't have one thing that I can say with the exception of sleep. I think sleep monitoring has always been. And it's changing. Like what I used to do to monitor an athlete's sleep, you know, even five years ago is totally different than what I'm doing now. And they're not perfect yet. You can trust me. Like a lot of these devices. Whoop. And Biostrap. Biostrap is my favorite Whoop. I don't. I'm just not down with paying a subscription every month for that type of service. And you're not getting what you think you're getting out of it yet. You know, maybe if there ever was. And I'm very, very interested in biometrics right now. It's like super interesting to me. But sleep is definitely something that you can kind of help with your athlete. And you don't necessarily have to do it to the level I am, where I'm going over there, how they slept each night, how much time they spent deep sleep, you know, how much REM they had. And you know, you're trying and you're basically most of the devices now you're making a guess. There used to be a device that was around that they would wear as a headband and you were getting some actual brainwave, like more accurate activity levels. Yeah. But it went out of business, unfortunately. But it gave me better data. But this is. The newer devices are, you know, they're getting better and it's kind of where we're headed in biometrics. So if you had to ask me what the one thing. It's definitely sleep and then nutrition. Overall, those are the two pieces. But again, my whole book is on the six pillars of recovery. So my, you know, my first instinct is there is no one thing that's the fallacy. Like you can't go to like. I think we talked a little bit about the cryo chambers and I'm sure you're going to get some hateful tech messages below this video because I don't really think it's a viable business model. I'm sure there are people making money using that particular device, but I just. It's just not going to make. It doesn't make sense to me. Not for a sports injury recovery now if you're doing that because you're doing intermittent fasting and you're trying to do cold treatments to your body for autoimmune disorders and stuff like that, and it's part of your protocol and that's different as your patients are coming in. But like the way I feel with ice, I mean, there's an entire book that written that says that we shouldn't be icing even acute injuries, you know, and he's backing it up with research and science, you know, so there's debate on this whole topic. And I've flip flopped and gone all around this because it's such a hot debatable topic, you know, and I'll kind of give you my two kind of points of view on it. Yeah, please. I mean, so like, of course we've learned it's an acute injury, right? So there's inflammation, we want to control inflammation, right. So you use ice to vasoconstrict the blood vessels, decrease the inflammatory cascade and the response. But I would. The flip side to that is there's also physiological changes that occur when you train, right? And the whole point is the overload, that principle where you're overloading everything. And it's not just your fibers of your muscle tissue. You know, there's things happening in your mitochondria. This thing's happening hormonally to you. And what happens when you chill the entire body, you're lowering the response, right? You're decreasing everything that's going on. So who's to say that that partial inflammatory response is not a good thing and that it is creating adaptation? You know, maybe you're retarding your adaptation potential, right? So why would you then jump in and as a pro to just say, okay, everyone's got an ice now throw in the fact that they have to drive to your clinic. This athlete, after working out, especially at the pro level. I mean, my guys, I don't. Because, you know, we're doing two a days for hours and then they're going to get in a car, drive to the clinic, get it, get, you know, get ice, get cryo chamber and then drive back home, you know, like, and if they're in la, it takes them two hours. Like, does that make any sense to you at all? No. You're not recovering, you're not resting and then you got to train an hour. Like makes no sense to me. Especially when you can take a cold shower. And there's studies that are very, very similar, you know, and I'm sure they're going to bombard me with whatever research the companies give you that then turn out to have 15 subjects in it. But you could get a similar thing. So I'm not completely against cold. I'm not even against the chambers. I'm not saying any, you know, completely. I just. You have to look at what the athlete needs. What do they need? Can they get away with a cold shower at the end of a workout? Can they get away with a cold tub bath? You know, and that's cheap and easy. You know, where do you spend your dollars for this athlete? That's a whole nother thing. Is it nutrition? Is it food? Is it sleep? Is it. Because there's so many devices and so many, you know, the trainers are going to want to do what they're going to do, and there's sometimes money invested in that. But, you know, when we have like, Amir Khan, who's making millions of dollars per fight, then it doesn't matter. I get. He's got to cook. You know, a chef is making his food for him. So for nutrition and any supplement I want, he's never going to balk out, you know, sleeping at altitude and having an oxygen chamber and we could do anything with guys like that. But it's the, the bread and butter people that you. Or Olympians that you really got. What's the bang for the buck? You know, I mean, it looks sexy on Instagram and you have Floyd Mayweather in there with his gloves and everybody, but trust me, they're not going back all the time. Not, you know, they're getting paid or they're just doing it and then like, I don't feel like doing this anymore.

You know, no shortage of widgets out there, that's for sure.

No, there's no shortage. It's well said, no shortage of widgets. And what's the sport, you know, are we talking about boxing and mma, where you're in football, where you're a lineman and you got to perform the next week? You know, do you need, you know, do you need ice and ice baths and cryo? Yes. Yeah, that, that's an instance. There's so much acute inflammatory response. It's really. There's way more benefit to that than. But like an Olympic high jumper. Does she need to jump in a, in a cryo chamber right after her workout? No, we're not doing that.

I think there's so much. I think we just skimmed the surface. So I'm definitely gonna. I'm preemptively asking you to come back on because I Think there's so much that we can dive into. But for anybody that's listening and watching, that wants to learn more about, you know, where you are, what you're up to, where, where can you point and direct them.

I think for now the best spot is my Instagram page, you know, just rickrosa. And if you message me, I'm famously always getting back to whoever. If you're a Cairo, you know, especially young Cairos, you know, I will help you out, I will get on the phone, especially if you're an NYCC grad. But I'll end, you know, because I'm.

The preferential getting the primary inbox. If you're an NYCC grad, General, yeah.

You get the VIP treatment. But no, I really do want to help our profession as much as I can and I feel that I've been. Everything I have in my life is from chiropractic and I'm really happy. And so I'm trying to do as much as I can for the generation that's with me or behind me and you know, just to try to make this whole thing grow. Because I think we have a huge value and also I think we're a great niche for what the type of stuff I'm doing and I think it's really interesting. It's, it's because you could just, you know, soft tissue and adjustments after a while can get a little bit, you know, for me it got boring after a while, right? It's not, you know, that's why the athletes are so exciting, because they have complicated issues. You know, there's nothing more exciting to me than someone, you know, like Amir Khan. I get a call from California saying no one's able to fix his hip problem. He's got to fight and five weeks and you're the, you know, I'm giving them your name and number and they, you know, they fly you out. Talk about pressure, right? They fly for a week and you got a week to friggin solve this problem. And it's not like they care that he's had this since he was 17 in the Olympics. They want you to fix this. You know, there's a lot of money involved and, and all the problems you have with that. You know, you show up at a gym not invited by the trainer, the head trainer, as a chiropractor and he already had a chiropractor. You know, it's like what it's like it's a very delicate dance you're trying to do, you know, so I mean, I'VE kind of seen it all. I think I can imagine. I'm still learning. I'm still learning, man. I'm still trying to learn as much as I can.

Constant, constant work in progress.

So yes, that's, that's me.

Sweet. Well, Rick, I really appreciate having you on and I would encourage docs if you are interested in sports chiropractic performance recovery please click the link below. Hit up Rick. We're going to go into subsequent episodes. He has an entire clinic enterprise. He is involved also on the product side with some really cool stuff that we'll dive into in future episodes. But Rick, I really appreciate you coming on.

Hey thanks for having me. I appreciate it. Thank you for joining us on this episode of the Evidence based Chiropractor. If you want to grow your practice, come back for next week's episode. If you want to grow faster, visit theevidencebasedchiropractor.com and join our MD Marketing membership today.