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    Health & Fitness

    Healthy Wealthy & Smart

    The Healthy Wealthy & Smart podcast with Dr. Karen Litzy is the perfect blend of clinical skills and business skills to help healthcare and fitness professionals uplevel their careers.

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    Copyright: © 2010 - 2018 Karen Litzy

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    Latest Episodes:
    227: Dr. Evangelos Pappas: ACL Rehab & Research 101 Aug 29, 2016
    Show notes

    On this week's episode of the podcast, I welcome Dr. Evangelos Pappas back onto the show to discuss current research on ACL rehabilitation. Dr. Pappas is a Senior Lecturer within the Discipline of Physiotherapy with expertise in sports medicine and musculoskeletal physiotherapy at the University of Sydney. He has published extensively in journals in sports medicine, musculoskeletal physiotherapy and biomechanics and he has presented his work in more than 50 national and international conferences. Dr. Pappas research passion is to develop programs that effectively prevent lower extremity injuries and identify rehabilitation techniques that provide optimal outcomes for injured athletes.

    In this episode, we discuss:

    -Biomechanical deficits that predispose athletes to ACL injury

    -Treatment interventions and screening assessments for return to sport that reduce the likelihood of re-injury

    -Training programs on ACL injury prevention

    -Wearable technology's impact on future ACL injury statistics

    -And so much more!

    Dr. Pappas is critical of physical therapy interventions that do not address deficits that could predispose the athlete to re-injury. He stresses, "Even though it is relatively easy to rehabilitate somebody after an ACL reconstruction in terms of regaining strength, range of motion, and even some proprioception, and even getting them ready for sports, I would strongly argue we are providing a disservice to this patient if we don't take it a step further and try to identify the biomechanical deficits that would potentially predispose them to an ACL tear and try and rectify those…"

    ACL injuries not only affect the athlete at the time of injury and throughout rehabilitation but also may lead to lasting adverse health effects. Dr. Pappas states, "You have an athlete with an ACL tear at age 16 who develops osteoarthritis because that commonly happens within the next 10-15 years… They're supposed to be in their most productive years and there are not many good choices because they are too young for a total knee replacement and their knee related quality of life is similar to someone who is 70 or 80 years old. We are very passionate about preventing those injuries because once they happen there are things we can do to prevent it from getting worse or getting another injury but just the fact that it happens it can really be a life defining event."

    The FIFA 11 + is a successful injury prevention program because it is incorporates an easy-to-follow dynamic warm-up into the daily practices of athletes. "The athlete does a 10 minute warm-up, they will have to do it either way. They have a choice of doing something that is ineffective like static stretching or they have the choice of doing something that is probably a little bit more fun and also effective… The same exercises that prevent the injuries are also good at making athletes run faster or jump higher and have a competitive advantage over their opponents."

    New research has found that athletes who have deficits in the single hop test still present a year post ACL reconstruction have a higher likelihood of re-injury. Dr. Pappas cautions, "Almost nobody should be returning to sport before 9 months after an ACL reconstruction. The knee will feel okay, especially if they had some allograft with no other side morbidity, but it's the job of the PT to discourage and convince the athlete to not return to sport earlier than 9 months after the ACL reconstruction."

    For more on Dr. Pappas:

    Professor Evangelos Pappas trained as a physiotherapist in Thessaloniki, Greece before pursuing a Masters in Orthopaedic Physical Therapy at Quinnipiac University and a PhD in Orthopaedic Biomechanics at New York University in the USA. Prior to coming to the University of Sydney, He taught for 11 years at Long Island University-Brooklyn Campus in kinesiology, clinical decision making and musculoskeletal pathology and physiotherapy. His excellence in teaching was recognized by his nomination for the Newton award for excellence in teaching. A/Professor Pappas joined the University of Sydney as a Senior Lecturer in 2013 where he continues to lecture in the areas of musculoskeletal physiotherapy, and particularly as it relates to the upper and lower extremities.

    Professor Pappas is also active in musculoskeletal research. His research has been funded by the National Institutes of Health and intramural grants. He has presented his work in more than 50 national and international conferences and he has been interviewed on the radio as an expert on knee injuries. His publications appear in top journals in the fields of physiotherapy, sports medicine and biomechanics. One of his publications received the T. David Sisk award for best review paper from Sports Health; a leading multidisciplinary journal in sports medicine. In addition, A/Professor Pappas has served on the research subcommittee of the awards committee of the American Physical Therapy Association.

    Resources discussed in this show:

    Dance Research Collaborative

    University of Sydney: Evangelos Pappas

    FIFA 11 +

    Kyritsis, Polyvios, et al. "Likelihood of ACL graft rupture: not meeting six clinical discharge criteria before return to sport is associated with a four times greater risk of rupture." British journal of sports medicine (2016): bjsports-2015. Link: http://bjsm.bmj.com/content/early/2016/05/23/bjsports-2015-095908.abstract

    Myer, G. D., Martin, L., Ford, K. R., Paterno, M. V., Schmitt, L. C., Heidt, R. S., ... & Hewett, T. E. (2012). No association of time from surgery with functional deficits in athletes after anterior cruciate ligament reconstruction evidence for objective return-to-sport criteria. The American journal of sports medicine, 40(10), 2256-2263. Pubmed link: http://www.ncbi.nlm.nih.gov/pubmed/22879403

    Make sure to follow Dr. Pappas on twitter and facebook! You can reach out to him with your questions via email evangelos.pappas@sydney.edu.au! Listen to Dr. Pappas first discussion on the show here!

    Thanks for listening and subscribing to the podcast! Make sure to connect with me on twitter and facebook to stay updated on all of the latest! Show your support for the show by leaving a rating and review on iTunes!

    Have a great week and stay Healthy Wealthy and Smart!

    Xo Karen

    P.S. Do you want to be a stand out podcast guest? Make sure to grab the tools from the FREE eBook on the home page! Check out my latest blog post on The Do's and Don'ts of Social Media!


    226: Dr. Rich Severin: An Open Door to the Ivory Tower Aug 22, 2016
    Show notes

    On today's episode, I had the pleasure of welcoming Dr. Richard Severin PT, DPT, CCS back onto the show to address audience questions on pursuing a terminal degree and entering the world of academia. Dr. Severin is a physical therapist currently pursuing his PhD in Rehab Science at the University of Illinois at Chicago with a focus in cardiovascular physiology.

    In this episode, we discuss:

    - What it takes to get accepted into the right PhD program for you including how to find a mentor and develop a competitive advantage

    -Differences between each terminal degree and their job prospects

    -Is it possible to manage DPT debt and clinical work while you pursue a PhD?

    -The changing academic world and growth in the job landscape

    -And so much more!

    The ideal PhD program for you comes down to finding the right mentor. Dr. Severin's advice is to, "Find someone who does research that you are interested in. The PhD really is mentor driven. Usually if you're considering going down that road, you have a list of researchers or authors you follow—you kind of know who they are already. So that's the first step, finding the person. If you have discourse with them, reach out to them. And if not, you're not going to get a negative response from cold emailing and just say, 'Hey, these are my interests, I would consider applying here, what are your opportunities?'"

    Dr. Severin believes that the academic world is allowing for more entrepreneurial pursuits to support your income. He states, "You've got to eat what you kill. You've got to find ways to find revenue. Historically, patents weren't something that contributed to rank and tenure and now they are starting to count. Social media is going to be a bigger thing now... Academia is starting to wisen up—which I think is good."

    Before applying to a PhD program, develop research experience to show that you can bring value. Dr. Severin recommends to, "Get a little bit of a taste of what it means to work in a lab before you commit yourself to 3 to 5 years of it. And that will look good on your application. There are usually 1 or 2 spots in most places, and if it's a good lab with good researchers those are going to be very competitive spots. Sometimes even if it's a smaller lab, funding is a scarce resource. It gives you a little bit of a taste, gives you an expectation of what you're going to be doing, and it also shows you can do certain things. A lot of times it is what you can contribute to our lab, goes back to those scarce resources, they want to bring in people who are going to contribute."

    Dr. Severin is optimistic about the prospects of researchers and clinicians bridging together to validate clinical practice with evidence. "There is so much [data] out there that if we can find a way to harvest that data, process it, that's going to be huge for us. When we talk about proving our worth, imagine if we could get all the outcomes from all of the PTs and find out what is going on here, we can really have some strong numbers that can combat different organizations or insurance companies who are trying to take away our reimbursements."

    For more about Dr. Severin:

    Dr. Severin is a physical therapist and ABPTS certified cardiovascular and pulmonary specialist. He completed his cardiopulmonary residency at the William S Middleton VA Medical Center/University of Wisconsin-Madison which he then followed up with an orthopedic residency at the University of Illinois at Chicago (UIC). Currently he is working on a PhD in Rehab Science at UIC with a focus in cardiovascular physiology. In addition to research, teaching and clinical practice regarding patients with cardiopulmonary diseases, Dr. Severin has a strong interest in developing clinical practice tools for risk assessments for physical therapists in a variety of practice settings. He is an active member within the APTA and serves on the social media committee and Heart Failure Clinical Practice guideline development team for the cardiopulmonary section.

    His research interests include: Assessment of cardiovascular risk in orthopedic physical therapy patients, hemodynamic responses to orthopedic rehab, Heart Failure, End Stage Lung Disease, Transplant Rehab, Exercise Physiology, Sport Performance, Peripheral muscle changes with cardiopulmonary and metabolic diseases, Tendinopathy

    Resources discussed on this show:

    List of PhD programs

    UIC Integrative Physiology Laboratory Twitter

    Clinical Rehabilitation and Technology Research Certificate

    Rehab Review Youtube Channel

    You can find more from Dr. Severin on twitter, facebook, and his website PT Reviewer!

    Thanks for listening and subscribing to the podcast! Make sure to connect with me on twitter and facebook to stay updated on all of the latest! Show your support for the show by leaving a rating and review on iTunes!

    Have a great week and stay Healthy Wealthy and Smart!

    Xo Karen

    P.S. Do you want to be a stand out podcast guest? Make sure to grab the tools from the FREE eBook on the home page! Check out my latest blog post on The Do's and Don'ts of Social Media!


    225: Dr. Claire Hiller: Rehabilitation for Dancers Aug 15, 2016
    Show notes

    On this week's episode of the Healthy Wealthy and Smart Podcast, I welcome Dr. Claire Hiller to the show to introduce us to dance medicine and how physiotherapists can break into the industry. Dr. Hiller is a physiotherapist specializing in dance injuries and her current research interests at the University of Sydney include further development of the Cumberland Ankle Instability Tool, prevalence and impact of chronic ankle problems, predictors of chronic ankle instability, dancers' lower limb injuries, and dance footwear.

    In this episode, we discuss:

    -Common injuries of the spine, knee, and ankle seen in dancers

    -In-depth analysis of the lateral ankle sprain vs the high ankle sprain and differential diagnosis

    -Pre-pointe assessments and when to give your dancer the green light

    -How a medical professional can effectively collaborate with dancer, dance teacher, and parent

    -And so much more!

    Dr. Hiller encourages physical therapists to pursue their interest in dance medicine by taking continuing education courses regardless of their current background. She states, "Physical therapists and other allied healthcare professionals are trained to watch people move… Dancers are very forgiving, if you even show a glimmer of the fact that you have an understanding of just the basics that go into dance, and you know what to look for and how to look for it, and you understand the body and how it moves and how it all connects, then you can be just as good if that's the field you want to go into."

    In dancers, lateral ankle sprains usually don't occur in isolation and a full ankle assessment is necessary for a realistic prognosis back to sport. From her experience, Dr. Hiller has found, "Dancers will often do something at the base of the outer part of their foot. Dancers can also have a high ankle sprain component again because they are coming down from a [demi-pointe position] and that's often missed. People will go back far too soon if they have that. It's a really important injury to stay longer off than even your lateral ankle sprain."

    Dr. Hiller believes that parents should be tuned into their child's complaints of pain and advocate early on for preventative care. "Some ways of training is you power on through everything. The life of a dancer is to live with pain, to be able to cope with pain. When you have pain, it is nothing unless you're laid out on the floor and can hardly move. If your child is complaining of pain, and their consistently complaining of pain, don't wait till they are nagging you that they're having pain. Listen to them when they start to say they have pain in my back, pain on the side of my knee, pain in my ankle, pain in my foot."

    Physical therapists have the training to facilitate a safe progression to pointe. Dr. Hiller illustrates this role, "A pre-pointe assessment is about whether your child is actually ready for that step of putting your pointe shoes on. It's not just about being able to put the pointe shoes on and balance, you've got to be able to have the strength and the control at a certain level before you can safely get up on your pointe shoes. And not just safely, once you get up there and actually be able to do something and enjoy it."

    For more about Dr. Hiller:

    Dr. Hiller has been awarded a Postdoctoral Fellowship at the University of Sydney to study ankle sprain and instability. Her current works aims to build on her doctoral studies which included: the development of the Cumberland Ankle Instability Tool (CAIT), an objective measure of functional ankle instability; finding bilateral changes following unilateral ankle sprain; and proposing a modified model of chronic ankle instability. Dr. Hiller is also a practicing physiotherapist with a special interest in dance injuries. She has been involved in convening specialist interest days at the International Association of Dance Medicine and Science Annual Meetings and recently co-convened the 4th International Ankle Symposium.

    Current research interests include: further development of the CAIT, prevalence and impact of chronic ankle problems, predictors of chronic ankle instability, dancers' lower limb injuries, and dance footwear.

    Resources discussed in this show:

    International Association for Dance Medicine and Science

    Harkness Center for Dance Injuries

    Dance Movement Therapy Association of Australasia

    National Institute of Dance Medicine and Science (NIDMS)

    Ausdance

    Healthy Dancer Canada - The Dance Health Alliance of Canada

    Performing Arts Medicine Association (PAMA)

    Articles mentioned in today's podcast:

    1) Liederbach MJ et al (2008) Incidence of anterior cruciate ligament injuries among elite ballet and modern dancers. American Journal of Sports Medicine 36: 1779-1788

    2)Sman AD et al (2015) Diagnostic accuracy of clinical tests for ankle syndesmosis injury British Journal of Sports Medicine 49:323-329

    3) The Hazards of Ankle Sprains NYT July 25th 2016

    Dr. Hiller invites you to reach out via email (claire.hiller@sydney.edu.au) and connect with researchers, clinicians and students interested in dance related research at Dance Research Collaborative!

    Thanks for listening and subscribing to the podcast! Make sure to connect with me on twitter to stay updated on all of the latest! Show your support for the show by leaving a rating and review on iTunes!

    Have a great week and stay Healthy Wealthy and Smart!

    Xo Karen

    P.S. Do you want to be a stand out podcast guest? Make sure to grab the tools from the FREE eBook on the home page! Check out my latest blog post on Managing Expectations: It Shouldn't be That Difficult!


    224: Sex!?! Part 2 Aug 08, 2016
    Show notes

    Thanks for tuning in to the Healthy Wealthy and Smart Podcast! Coming to you from Chicago, Drs. Sarah Haag, Sandy Hilton, and Jason Falvey join me for Part 2 on our discussion all about sex! You can check out Part 1 from CSM in Anaheim, California here in case you missed out!

    In this episode, we discuss:

    -Broaching the subject of sex with your patients

    -Recalibrating sex after surgery and childbirth

    -Rising rates of sexually transmitted diseases in the older adult population

    -How a bladder diary can help those with persistent UTI

    -And much, much more!

    Sex has multiple health benefits outside what is commonly perceived and can be utilized as exercise. "There is so much that sex is good for cardiovascularly, musculoskeletally. It's just awesome for so many reasons mentally. When we talk about population health and things that keep people moving and happy—that's a good one."

    Sex is an important activity of daily living and can be a tool for clinicians to implement into their home exercise program. "Pleasurable movement is one of the things that help you get back to normal movement. So if you can make this make sense and feel good, it's probably going to be one of the first and well motivated things you're going to do in an exercise program."

    After patients have undergone surgery, surgical restrictions are not you're only guiding tool for sex. "Always let pain be your guide, if it hurts, don't do it. Sex is never supposed to hurt—it's supposed to be amazing."

    We tend to forget about the vital functions our pelvic organs perform every day. "Peeing and pooping and sex, they are all very basic bodily functions and we can start to forget about it. If I ask any of you how often you peed today, you would have to think really hard and I betcha 10 bucks you'd be wrong with whatever you guessed. You can go pee mindlessly."

    Today's guests:

    Sandy Hilton PT, DPT, MS: Sandy graduated from Pacific University (Oregon) in 1988 with a Master of Science in Physical Therapy and a Doctor of Physical Therapy degree from Des Moines University in December 2013. She has worked in multiple settings across the US with neurologic and orthopaedic emphasis combining these with a focus in pelvic rehabilitation for pain and dysfunction since 1995. Sandy has teaches Health Professionals and Community Education classes on returning to function following back and pelvic pain, assisted with Myofascial Release education, and co-teaches Advanced Level Male Pelvic Floor Evaluation and Treatment. Sandy's clinical interest is chronic pain with a particular interest in complex pelvic pain disorders for men and women. Sandy is also pursuing opportunities for collaboration in research into the clinical treatment of pelvic pain conditions. Sandy brings science and common sense together beautifully to help people learn to help themselves.

    Sarah Haag PT, DPT, MS, WCS Cert. MDT, RYT: Sarah graduated from Marquette University in 2002 with a Master's of Physical Therapy. Sarah has pursued an interest in treating the spine, pelvis with a specialization in women's and men's health. Over the past 8 years, Sarah has seized every opportunity available to her in order to further her understanding of the human body, and the various ways it can seem to fall apart in order to sympathetically and efficiently facilitate a return to optimal function. Sarah was awarded the Certificate of Achievement in Pelvic Physical Therapy (CAPP) from the Section on Women's Health. She went on to get her Doctorate of Physical Therapy and Masters of Science in Women's Health from Rosalind Franklin University in 2008. In 2009 she was awarded a Board Certification as a specialist in women's health (WCS). Sarah also completed a Certification in Mechanical Diagnosis Therapy from the Mckenzie Institute in 2010. Most recently, Sarah completed a 200 hour Yoga Instructor Training Program, and is now a Registered Yoga Instructor. Sarah plans to integrate yoga into her rehabilitation programs, as well as teach small, personalized classes. Sarah looks at education, and a better understanding of the latest evidence in the field of physical therapy, as the best way to help people learn about their conditions, and to help people learn to take care of themselves throughout the life span.

    Jason Falvey PT, DPT, GCS: PhD Student Jason Falvey was awarded a Kendall Scholarship from the Foundation for Physical Therapy in 2014 and a Fellowship for Geriatric Research through the Academy of Geriatric Physical Therapy in 2015 to support his research examining the role of home physical therapy in enhancing function and reducing re-hospitalizations for medically complex older adults. He is also the primary investigator on a research grant from the American Physical Therapy Association, Section of Health Policy and Administration looking at the role of physical therapists in models of transitional care for older adults after acute hospitalization.

    Resources discussed in this show:

    Oswestry Disability Index

    Finding a pelvic health PT

    Holly Herman

    Make sure to give Jason Falvey , Sarah Haag , and Sandy Hilton a follow on twitter!

    Thanks for listening and subscribing to the podcast! Make sure to connect with me on twitter to stay updated on all of the latest! Show your support for the show by leaving a rating and review on iTunes!

    Have a great week and as always stay Healthy Wealthy and Smart!

    Xo Karen

    P.S. Do you want to be a stand out podcast guest? Make sure to grab the tools from the FREE eBook on the home page! Check out my latest blog post on Managing Expectations: It Shouldn't be That Difficult!


    223: Dr. Kelly Starrett: Movement, Pain Science & Non-profits. Aug 01, 2016
    Show notes

    Today's show is with Dr. Kelly Starrett where he answers audience questions concerning how he optimizes human performance. Kelly is a coach, physical therapist, author, speaker, and creator of the blog Mobility WOD. Kelly's work across these mediums has reached large audiences and revolutionized how athletes think about human movement and athletic performance.

    In this episode, we discuss:

    -Allied relationships between physical therapists and strength and conditioning coaches

    -Do anatomical variations impact ideal posture and movement?

    -Why we should be taking a 30,000 foot view in our culture

    -How Kelly reconciles pain science and biomechanics in his physical therapy practice

    -How to build a large platform with the use of social media

    -And so much more!

    Kelly advocates that every human should be incorporating a mobility regime into their day to day lives. He states, "What does it mean foundationally to be a human being, what are the things we should be able to do? We remain agnostic about the way you want to train, but you better have a movement practice or at least express full range of motion if you plan on moving fast, lifting heavy, going up and down stairs, or picking up your kid."

    Kelly stresses that enhancing movement is a continual process and every day is a movement screen. "We don't expect movement competence to happen overnight. This is a process but eventually we should all be moving better and better and better because that is what it means to acquire skills as a human. It takes 10,000 repetitions as a baby to integrate a movement pattern. That means we have some tolerance in the system to buffer some less than ideal biomechanics. Overtime we should be refining that."

    Kelly challenges the physical therapy profession to focus more attention on educating the public on preventative care. He stresses, "When you have a fever, you take some Tylenol. If you have a cold, you don't go see your doctor. If you have a cut, we teach people basic first aid. [Physical therapists] are not doing a good job teaching basic first aid around the body to everyone."

    We also discuss Kelly's widely successful online fitness platform and the best ways to target and gain influence in your own local community. He states, "People are looking for advocates, they are looking for help… if you set out to influence a bunch of people, you influence no one. It's not authentic, it's not real. Solve a set of problems and be of use to your community and people will find you."

    For more about Kelly:

    Kelly Starrett is a coach, physical therapist, author, speaker, and creator of [mobilitywod.com], which has revolutionized how athletes think about human movement and athletic performance.

    His 2013 release, Becoming a Supple Leopard has become a New York Times and Wall Street Journal bestseller. [His] blog was voted #4 in Outside Magazine's Top 10 Fitness Blogs of 2011, Breaking Muscle's Top 10 Fitness Blogs of 2011, and Health Line's Top 100 Health Blogs of 2011. Kelly and his work have been featured in Tim Ferris' Four Hour Body, Competitor Magazine, Inside Triathlon, Outside Magazine, Details Magazine, Power Magazine, and the Crossfit Journal.

    He teaches the wildly popular Crossfit Movement & Mobility Trainer course and has been a guest lecturer at the American Physical Therapy Association annual convention, Google, the Perform Better Summit, the Special Operations Medical Association annual conference, police departments, and elite military groups nationwide.

    Coach Kelly Starrett received his Doctor of Physical Therapy in 2007 from Samuel Merritt College in Oakland, California.

    Before starting his own physical therapy practice at San Francisco CrossFit, one of the first 30 CrossFit affiliates, he practiced performance-based physical therapy at the world-renowned Stone Clinic. In his current practice, Kelly continues to focus on performance-based Orthopedic Sports Medicine with an emphasis on returning athletes to elite level sport and performance.

    Kelly's clients have included Olympic gold-medalists, Tour de France cyclists, world and national record holding Olympic Lifting and Power athletes, Crossfit Games medalists, ballet dancers, military personnel, and competitive age-division athletes.

    Kelly's background as an athlete and coach includes paddling whitewater slalom canoe on the US Canoe and Kayak Teams, and leading the Men's Whitewater Rafting Team to two national titles and competition in two World Championships. In his free time Kelly enjoys spending time with his wife Juliet and two daughters, Georgia and Caroline, surfing, paddling, Olympic lifting, hot-tubbing, and so-you-think-you-can-dancing.

    Resources discussed on this show:

    Stand Up Kids

    Chris Powers

    Dan Pfaff

    Functional Movement Screen

    Lorimer Moseley

    David Butler

    Greg Lehman

    International Spine and Pain Institute

    PTPintcast

    Kelly welcomes you to stop by his clinic in San Francisco, California and see what he's all about. You can find more from him at Mobility WOD and follow him on twitter!

    Join me and other professionals for PT Day of Service this October 15th and give back to your local community!

    Thanks for listening and subscribing to the podcast! Make sure to connect with me on twitter to stay updated on all of the latest! Show your support for the show by leaving a rating and review on iTunes!

    Have a great week and as always stay Healthy Wealthy and Smart!

    Xo Karen

    P.S. Do you want to be a stand out podcast guest? Make sure to grab the tools from the FREE eBook on the home page! Check out my latest blog post on Managing Expectations: It Shouldn't be That Difficult!


    222: Amy Mewborn: Escaping the 9 to 5 Jul 25, 2016
    Show notes

    On today's episode, Amy Mewborn discusses how she jumpstarted her career and now designs strategies for others to do the same. Amy is a serial entrepreneur, CEO, author, and operations and strategy expert. She teaches women business owners how to use technology and systems to leverage their business growth and maximize profits through automation.

    In this episode, we discuss,

    -Amy's health journey and how she escaped the 9-5

    -Building an information highway through automation technology

    -What to do if your launch falls flat in the online space

    -Mindset challenges women need to address to kick start their business

    -And so much more!

    Amy discusses the importance of taking action when branching out into new business opportunities. In Amy's experience, she states, "You have to have the courage to take a risk, because if you don't, one day you will wake up and your entire life will go by and you've been going through the motions but never really got to where you want to be. Listen to your intuition, no one knows what is better for you than you do yourself and do as much research and be as well prepared as you possibly can."

    Amy describes the reciprocal relationship between passive income streams and personal independence as a result of automation. She states, "The more time that you can free up from the things that you are doing, the more revenue streams you can potentially create, the more income you can have, the more clients you can see, and the more time you can have off and have fun…That's when our creative energy starts to flow."

    Amy embraces taking risks because failure can offer an equally beneficial learning experience. From her experience, she states, "Had I given up after falling flat on my face the first time, I would have just thought I would never be able to make it… it's just about going back and looking at what worked and what didn't work and how you're going to adjust going forward."

    For women who are hesitant to pursue a new venture, Amy reassures us that, "As women, we always wonder if we are good enough—is what I have to offer really any different or more valuable or anything better than what is already out in the market place? We don't think about how we do business with people we know, we like, and we trust… We constantly have to break through that mindset that we are not enough because there is probably someone out there who is just like us and is waiting for us to share our gifts and secrets with the world."

    For more information about Amy:

    Amy Mewborn is a serial entrepreneur, CEO, author, and operations and strategy expert. She teaches women business owners how to use technology and systems to leverage their business growth and maximize profits through automation.

    She has spoken with Carlsbad Chamber of Commerce, Healthy Living Expo, Health and Wellness Expo, and Blastoff Business Breakthrough. She has been a featured teacher and continuing education provider with the American Council on Exercise. Amy has been featured on CBS, KUSI, Fox, Ivillage, San Diego Magazine, Ranch and Coast, and is a contributing editor to a number of publications.

    She is a sought after speaker on business topics surrounding increasing profitability through technology, systems, and automation.

    Her passion is helping women business owners achieve financial independence, and every speech or educational program that she produces is designed to teach women how to increase their business through systems and automation.

    Check out all the goodies Amy has for you on her website and send her your questions, comments, and concerns via email Amy@amymewborn.com.

    You can also get her book The Great Escape: The Successful Women's Guide to Escaping the 9-5 FREE this week only!(July 25, 2016 to July 30, 2016)

    You can find Amy on twitter, facebook, and instagram!

    Thanks for listening and subscribing to the podcast! Make sure to connect with me on twitter to stay updated on all of the latest! Show your support for the show by leaving a rating and review on iTunes!

    Have a great week and as always stay Healthy Wealthy and Smart!

    Xo Karen

    P.S. Do you want to be a stand out podcast guest? Make sure to grab the tools from the FREE eBook on

    the home page! Check out my latest blog post on Managing Expectations: It Shouldn't be That Difficult!


    221: Dr. Beth Darnall: The Opioid Epidemic Jul 18, 2016
    Show notes

    On this week's episode of the Healthy Wealthy and Smart podcast, Dr. Beth Darnall joins us to talk about the opioid epidemic and alternative treatments for patients experiencing chronic pain. Dr. Darnall is a Clinical Associate Professor in the Division of Pain Medicine at Stanford University and treats individuals and groups at the Stanford Pain Management Center. She is an NIH-funded principal investigator for pain psychology research that is examining the mechanisms of pain catastrophizing treatment, including a novel single-session pain catastrophizing class she developed (funded by the NIH National Center for Complementary and Integrative Health). She is dedicated to empowering life beyond pain.

    In this episode, we discuss:

    -The opioid epidemic and cost effective treatment solutions that you can incorporate into your care

    -Tapering off opioid use, associated effects, and protocol

    -How opioid use and chronic pain effect brain chemistry

    -Pain catastrophizing defined and what patients can do if they have chronic pain

    -And so much more!

    Treatment for chronic pain with opioids alone is not sustainable and alternative treatment approaches are needed to retrain the brain. The research has shown that, "When we take opioids, it really changes brain chemistry. It actually changes the structure of the brain but so does chronic pain itself…[With alternative treatment,] you're rewiring and recovering and exercise and enjoyment and going out and getting back to doing the things you love, these are going to help facilitate your brain as it is rewiring, as you're managing pain differently, as you're becoming more and more active and functional."

    Evidence based healthcare providers must monitor patients who begin opioid treatment for chronic pain and how their condition evolves. "We want to ask ourselves a critical question—are people getting better? And this is where we've really fallen short, opioids will be prescribed and nobody is tracking long term to see if they are getting better or if there are new risk factors or addictive behaviors. It's a constant process of monitoring… We need to do better at stopping what isn't working. If people aren't getting better, if their pain is only worsening, let's not add more of what isn't working. Let's stop it and emphasize the alternatives."

    Dr. Darnall supports the biopsychosocial model for treating chronic pain because it effectively and comprehensively targets the nervous system. She states, "The nervous system leads us into this area where we're really talking about the modulation of pain, the facilitation of pain and the exacerbation of pain… No matter where you feel pain in your body, no matter how it got started or why, the processing of it will occur in the brain and spinal cord. That's what we can target with some of these treatments and therapies, we're able to dampen the experience of pain… The nervous system is a critically important part in helping decrease not only pain and intensity but more importantly how much a person suffers from pain. "

    Dr. Darnall advocates a pain management approach that allows the patient to take more control in achieving a desirable outcome. She stresses, "The most important person on the healthcare team isn't the doctor or the psychologist or the physical therapist—it's the patient. If you have chronic pain, you are the most important person on your healthcare team. My hope and my wish is that every person on your healthcare team will have a similar philosophy that is focused on empowering you to acquire the right information and the right skills so you can best self manage your pain and your symptoms so that you're able to become more functional, to enjoy more of the life you have even with the health conditions you have so you're able to live your best life possible."

    For more about Dr. Darnall:

    Beth is a Clinical Associate Professor in the Division of Pain Medicine at Stanford University and treats individuals and groups at the Stanford Pain Management Center. She is an NIH-funded principal investigator for pain psychology research that is examining the mechanisms of pain catastrophizing treatment, including a novel single-session pain catastrophizing class she developed (funded by the NIH National Center for Complementary and Integrative Health).

    She is Co-Chair of the Pain Psychology Task Force at the American Academy of Pain Medicine (AAPM), and in 2015 received a Presidential Commendation from AAPM.

    Beth is author of Less Pain, Fewer Pills ©2014 and The Opioid-Free Pain Relief Kit ©2016. Her upcoming book, The Surprising Psychology of Pain: Evidence-Based Relief from Catastrophizing and Pain is due out in 2017. As a pain psychologist, she has 15 years experience treating adults with chronic pain, and she lived through her own chronic pain experience. She enjoys helping individuals with chronic pain gain control over mind and body and live their best life possible.

    Beth is a licensed clinical psychologist (CA License #25495).

    Beth received her doctoral training at the University of Colorado at Boulder and her clinical residency at the Southern Arizona Veterans Affairs Health Care System (Tucson VA Hospital). She received post-doctoral training at The Johns Hopkins University School of Medicine Department of Rehabilitation Medicine and the Bloomberg School of Public Health (T32 Fellowship). Clinically, she provided psychological services to patients with catastrophic burn, spinal cord injury or amputation. She was an Associate Professor at Oregon Health and Science University (2005-2012) prior to joining the faculty at Stanford University in late 2012. Her desire to specialize in the management of chronic pain was inspired by her clinical experiences and by her own personal experience with chronic pain.

    Make sure to grab copies of Dr. Darnall's books The Opioid-Free Pain Relief Kit: 10 Simple Steps to Ease Your Pain and Less Pain, Fewer Pills: Avoid the Dangers of Prescription Opioids and Gain Control over Chronic Pain and follow her on twitter!

    Thanks for listening and subscribing to the podcast! Make sure to connect with me on twitter to stay updated on all of the latest! Show your support for the show by leaving a rating and review on iTunes!

    Have a great week and as always stay Healthy Wealthy and Smart!

    Xo Karen

    P.S. Do you want to be a stand out podcast guest? Make sure to grab the tools from the FREE eBook on the home page! Check out my latest blog post on Managing Expectations: It Shouldn't be That Difficult


    220: Dr. Jason Falvey: Baby Boomer Rehabilitation Jul 11, 2016
    Show notes

    On today's episode, I had the pleasure of welcoming Dr. Jason Falvey PT, DPT, GCS onto the podcast to discuss how physical therapists can better treat the geriatric population. Dr. Falvey is currently pursuing his PhD at the University of Colorado Denver in the Muscle Performance Lab and is interested in optimizing rehabilitation for medically deconditioned older adults in post-acute and home care settings.

    In this episode, we discuss:

    -The push for more medically necessary research funding for the growing baby boomer population

    -Are fresh PT graduates prepared to manage older adults?

    -Jason's top strategies to break cemented patient routines

    -How to properly dose exercise for the geriatric population

    -And so much more!

    Jason explains the value of understanding optimal aging and long term health management when dealing with clients of any age and in any setting. He states, "In every practice area, knowledge of successful aging will make you a better therapist. If you're a geriatric specialist or have good knowledge in that area, I think you would be an incredible asset to any healthcare organization."

    Some of Jason's best treatment results come from empowering patient's on their rehabilitation journey. "These patients we see are often homebound, their often not respected or valued or heard by medical professionals… So really getting in and promoting autonomy and putting power in their hands immediately to take charge of their care. It's surprising how refreshing that is for patients and how much they open up after the first session."

    In order to maximize patient outcomes, clinicians need to understand the foundations of movement and address their patient's functional deficits. To better illustrate this point, Jason proposes this example, "If I gave you a book in Spanish and I tell you to read it, you read through it and you don't understand because you don't understand the foundation of the Spanish language and then I have you do 100 repetitions of reading that book, that 100th time you're not going to be any better at it because I didn't fix the foundational issue that you don't know some of the basic vocabulary you needed to understand."

    Geriatric research is now beginning to incorporate physical function into the equation and physical therapists are at the forefront for advocating its importance. Jason stresses, "Physical function is its own independent risk factor for so many adverse outcomes like hospital readmissions, all cause emergency room visits, falls, cognition and physical function often run in tandem… I think there is increased recognition that how people move and interact with their community is not just a secondary outcome but it is a primary outcome… They haven't included physical therapists in physician trials, so there is still work to do, but we have successfully promoted the message that mobility is important, mobility is a quality of life issue, and exercise is medicine and we need to integrate those things across the spectrum. "

    For more about Dr. Falvey:

    PhD Student Jason Falvey was awarded a Kendall Scholarship from the Foundation for Physical Therapy in 2014 and a Fellowship for Geriatric Research through the Academy of Geriatric Physical Therapy in 2015 to support his research examining the role of home physical therapy in enhancing function and reducing re-hospitalizations for medically complex older adults. He is also the primary investigator on a research grant from the American Physical Therapy Association, Section of Health Policy and Administration looking at the role of physical therapists in models of transitional care for older adults after acute hospitalization.

    You can find more resources on Jason's research here and follow him on twitter!

    Thanks for listening and subscribing to the podcast! Make sure to connect with me on twitter to stay updated on all of the latest! Show your support for the show by leaving a rating and review on iTunes!

    Have a great week and stay Healthy Wealthy and Smart!

    Xo Karen

    P.S. Do you want to be a stand out podcast guest? Make sure to grab the tools from the FREE eBook on the home page! Check out my latest blog post on Managing Expectations: It Shouldn't be That Difficult!


    219: Dr. Greg Lehman: The Beauty of Simplicity Jul 04, 2016
    Show notes

    Happy Independence Day to the American Healthy Wealthy and Smart family! On this week's episode, Greg Lehman and I review the evidence and rethink effective treatment strategies. Greg is both a physiotherapist and chiropractor who treats musculoskeletal disorders within a biopsychosocial model and simplifies pain science for clinicians around the world.

    In this episode, we discuss:

    -Why explaining pain leads to better treatment outcomes

    -The case for and against repeated spinal flexion

    -Does glute activation or inhibition affect pain?

    -Functional training and the carry-over effect

    -And so much more!

    Greg stresses that most physical therapists should rethink what is valuable to their patients. He states, "The technical mastery is less important…It probably has more to do with how your patient feels comfortable and how you respond to them rather than you being a good robot who knows lines of drive and the biomechanics. That isn't what is valuable and isn't supported in all the research that we have."

    Greg also questions the effectiveness of being so specific with our interventions and takes a broader approach in his treatment philosophy. "I don't think there is any treatment that ever has to occur… It's actually a neat, big question for therapy I would like to see addressed more. Is there ever a treatment that is absolutely necessary for a specific condition or are there a number of things that can be helpful? I tend to believe there are a number of things—I have my biases—but I think most things aren't that specific."

    Greg builds patient self-awareness with education and believes it is his most effective treatment tool. "I go right into education for low back pain. I am not too worried about getting them super active right away. I want to encourage them to getting back to doing the things that are important. If they tell me they are afraid to do a number of things that they like doing and they are meaningful activities, my go to intervention is to convince them they can start doing those things again."

    Greg suggests shifting our focus as clinicians from a purely biomedical approach to treatment and instead developing our psychosocial expertise. "I really believe it is okay to be simple. We don't really need the complexity that we try to do, especially the biomechanics. The big point of that is if you simplify your biomechanics, your physical interventions, it can allow you to develop your skills in the other areas, the psychosocial stuff and start taking more classes outside our typical training—psychologists, social workers, that type of stuff. That's where we can build our skill set. There's not a better manipulation, there's not that special exercise technique that you need to learn. It's fun but it's not necessary for patients with pain."

    For more about Greg:

    1. GREG LEHMAN BKIN, MSC, DC, MSCPT

    He is a physiotherapist and chiropractor treating musculoskeletal disorders within a biopsychosocial model.

    Prior to his clinical career he was fortunate enough to receive a Natural Sciences and Engineering Research Council MSc graduate scholarship that permitted me to be one of only two yearly students to train with Professor Stuart McGill in his Occupational Biomechanics Laboratory subsequently publishing more than 20 peer reviewed papers in the manual therapy and exercise biomechanics field. Greg was an assistant professor at the Canadian Memorial Chiropractic College teaching a graduate level course in Spine Biomechanics and Instrumentation as well conducting more than 20 research experiments while supervising more than 50 students. He has lectured on a number of topics on reconciling treatment biomechanics with pain science, running injuries, golf biomechanics, occupational low back injuries and therapeutic neuroscience. His clinical musings can be seen on Medbridge Health CE and various web based podcasts. Greg is currently an instructor with therunningclinic.ca and with Reconciling Biomechanics with Pain Science. Both are continuing education platforms that provide clinically relevant research that helps shape and refine clinical practice.

    While he has a strong biomechanics background he was introduced to the field of neuroscience and the importance of psychosocial risk factors in pain and injury management almost two decades ago. Greg believes successful injury management and prevention can use simple techniques that still address the multifactorial and complex nature of musculoskeletal disorders. He is active on social media and consider the discussion and dissemination of knowledge an important component of responsible practice. Further in depth bio and history of my education, works and publications.

    For more information on where Greg will be lecturing next, make sure to visit his website and keep up with Greg on twitter!

    Thanks for listening and subscribing to the podcast! Make sure to connect with me on twitter to stay updated on all of the latest! Show your support for the show by leaving a rating and review on iTunes!

    Have a great week and stay Healthy Wealthy and Smart!

    Xo Karen

    P.S. Do you want to be a stand out podcast guest? Make sure to grab the tools from the FREE eBook on the home page! Check out my latest blog post on Managing Expectations: It Shouldn't be That Difficult!


    218: Fastlane Your PT Career w/ Chad Prince, PT Jun 27, 2016
    Show notes

    On this week's episode of the Healthy Wealthy and Smart Podcast, Chad Prince joins me to discuss his book Physical Therapy Career & Salary Guide: Avoid the Income Ceiling and Put Your Career in the FASTLANE and strategies to add side income to your physical therapy practice. After working as a physical therapist for ten years, Chad transitioned into full-time administration seven years ago. Today, he manages an orthopaedic surgery practice. In his writing, he combines his years of professional business experience, his understanding of the healthcare world at large, and his personal journey developing a physical therapy product, the UELadder.

    In this episode, we chat about:

    -Chad's experiences with overcoming self-doubt and self-imposed limitations

    -Unique PT opportunities to generate income without trading your time for money

    -How to expand your audience globally and 10x the impact you can make

    -How to get in the fastlane of healthcare innovation

    -And much, much more!

    As budding entrepreneurs, sometimes it is our mindset that is limiting us from achieving greatness. Chad suggests exploring these questions, "What do you want to give? What kind of impact do you want to have on the world? Who do you have to become to give that to the world? And you have to go ahead and believe that you are capable of that before you can become it."

    Chad addresses the limitations of the service model and the upside of taking an alternative view, "As long as we trade time for money we are limited by our amount of time…You might be able to work more but there is no way to 10x your work hours—it's just not possible. But with online tools and with other types of businesses still inside physical therapy, it is possible to 10x your impact."

    As technology evolves in our profession, Chad stresses, "We've got to look ahead at changes that are coming and embrace those in a way that's positive and healthy for the profession and our patients. That's ultimately going to be the sweet spot for us all."

    We wrap up the interview with some lessons from the memory of a legendary figure, Muhammad Ali, "He said I'm the greatest and said it over and over and over until he became the greatest… If we can have a full and complete understanding of our what, why, and how, we can say I'm the greatest at whatever it is we want to accomplish and we can go do it."

    You can find more from Chad on twitter and can follow his blog here! Get a copy of the book and check out Chad's UELadder!

    Be sure to check out the FREE 5 page report on PT Income Tips on the homepage, thanks to Chad!

    Thanks for listening and subscribing to the podcast! Make sure to connect with me on twitter to stay updated on all of the latest! Show your support for the show by leaving a rating and review on iTunes!

    Have a great week and stay Healthy Wealthy and Smart!

    Xo Karen

    P.S. Do you want to be a stand out podcast guest? Make sure to grab the tools from the FREE eBook on the home page! Check out my latest blog post on Managing Expectations: It Shouldn't be That Difficult!


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