Breaking the Rules: What We Learned from FARM Intern Troy Briscoe About True Professional Growth

• Why traditional healthcare education falls short — and how real clinical growth happens through curiosity, questioning, and confronting uncertainty.

• What Troy learned at The FARM that changed his approach to assessment, movement, and patient care.

• The mindset shift every clinician needs to break free from algorithmic thinking and build true diagnostic clarity.

In this episode, Dr. Beau Beard and the FARM team sit down with intern Troy Briscoe to unpack his transformative experience at The FARM over the past few months. The conversation takes a deep dive into the real process of professional development—one that goes far beyond textbooks, protocols, and standardized techniques. Together, they explore why traditional learning methods often fail to prepare young clinicians for the complexity of real-world patient care. Dr. Beard and the team highlight the importance of independent thinking, questioning assumptions, and building your own clinical compass rather than blindly following algorithms. Suppose you're a student, intern, new graduate, or clinician who wants to elevate your diagnostic and reasoning skills. In that case, this episode will challenge you, inspire you, and expand the way you think about becoming truly excellent in healthcare.

Beau Beard (00:00.926)

Alex inevitably gets into a very spirited conversation right before we start recording and then when we start recording.

He puts the microphone where nobody can hear it and just stops talking. It's only when necessary. So we have a special edition podcast. So your actual last day is when? It'll be Wednesday next week. And then Troy's picking that next week. over here. his, so I'm leaving tomorrow for a trip. So this will be kind of close to the next day or last day I see Troy doing his last supper before death row.

tonight and he picked Oak House so I'm gonna have to get a loan to take him off to dinner tonight. And then we're doing a special edition because Troy with Troy Plus, right, with some listener questions and then, so he has questions for all of us or I guess the group, right, we'll all answer them or if maybe one's specific to somebody. And then we all have a few questions for Troy and yeah, we'll just see how far we get into this thing. And we're gonna start.

mostly with Troy and then if we get like he's got a couple left and we're on short on time, we'll get an arch for him too. So with that, any updates on anything, anybody's life? This is a podcast with microphones.

Well, that's solo concussions. I just take concussions. Yeah.

Beau Beard (01:36.717)

I have no clue. No clue. Um, Alex is going to Malta. be getting abs. Yeah. There's that. Yeah. Yeah. That's a big one. You want the extra 35 K and a 319. So was like a 21 mile or it's pretty good time for that. Yeah. And then I about died. Don't really the next day here, but um, yeah.

If anybody wants to come, I'm taking applicants. Yeah. Don't talk to us about your labs. No one wants them. Yeah. I'll be honest. We might discuss that. We already know what they're going to say. I told Troy I have been waiting for the shipment for the lab kit to come in and I went and checked the order status. They're not coming to me. I have to go to them. To where? To Quest, Brooklyn. Well, it's a quest. It makes sense. Which I reread the email and there was fine print.

Yeah, if you ordered outside of Quest, then they'd be coming to you in five or seven business days. I wouldn't do it. We can talk about this. This is super entertaining for everybody listening. And they definitely started the email with the first word he said, yeah. Yeah. All right. So let's get into it. We're going to get Troy. We have no clue what these questions are. He doesn't even know what order they're in. You sure you did like random. Yeah, I'm just going to roll through, see which one I want to ask. but let's get it going. Yeah. So we got a bunch of questions.

hot off the press. And let us know which ones are yours and which ones were somebody else. And if it's somebody you want to mention, go for it. If they wanted to remain anonymous because the questions dog pile. All that will be me will be ones I don't preface with the name. I'll give a shout out to those that come from a listener. Sounds good. Cool. All right. Without further ado, let's get it rolling. Let's see. So.

Beyond technical skill, what qualities defined an exceptional MSK practitioner in today's healthcare landscape?

Beau Beard (03:42.254)

everyone to start. We'll think about it. Give some dead air. guess Riverside will cut this out. So we'll just go straight to the answer. Does it really cut this stuff out? If you have a gap? I mean, basic ones. I mean, so again, I kind of try to make fun of it when I teach, but like, don't be a dick. So you have to keep people around long enough to be good at your job because you can be the best in the world. Nobody

keeps coming and that could be for a lot of reasons. You're not very good at business, which could be you've hired other people to do that part for you because you're not good at it, or you yourself are pretty good at managing. So you gotta keep them in the realm. Well, to keep them there, you gotta initially get them to kinda trust you and be somewhat amicable. So it's basically just being not necessarily a nice person. So I heard a good definition by Matthew McConaughey the other day between a nice guy and a good guy. It's like a good guy stands for something, is willing to be a little bit

gruff or have people not like him because he's like, well, if you're going to do that, then you can just leave. I think you got to be a good person. So what I mean by that is some people want to come in here and what we're offering is not for them. What they think we're going to give them doesn't match what they need or they're literally not a good fit for you as a clinician. think so you need to be a good person, necessarily a nice person because you can just get steamrolled all day and that's going to bug you and them. So yeah, I think that'd be one thing. This should be a good person. I like that. Except pretty broad, but yeah.

You can get really specific with that, but I think that's one thing. So here, I'll try to get something that maybe people won't think of. Not playing off what I teach, but I literally think that a lot of people go through school, memorize all the stuff, go to seminars, try to learn how to do stuff, and then they get out into practice and that's how they operate. I learned how this is the way it is. I learned how to do this from my mentors, which isn't a bad way to operate.

And they lack the ability to kind of think independently of what they're taught. And there's nothing wrong with that. So they go, you become an ART person, MPI, DNS, and you do that and maybe even go really far. You're like, I'm a DNS person. If you lack the ability to question that stuff, you'll hit, you could have a very successful career. You're going to hit a stop gap of how good of a, like you said, an excellent clinic, you're going to be, you will never be world-class.

Beau Beard (06:09.048)

you'll only be as good as the people you're basically mirroring. Right? So not that that's bad, right? You're going to be really good with the world class. Like you have to be able to like, you know, live with different thoughts and gray areas and challenge and integrate a bunch of, It's not just about like, we need somebody to create another method. think that's not what I'm saying. It's just like thinking about stuff independently. yeah. I think something that is similar, that goes a long way that people will

make note of is whenever you remember a small detail of something that they mentioned to you in the first visit, maybe pertaining to their case or just relating to their family or their like or interest, something that...

Many times if you hear them say, wow, I'm surprised you remembered that about their kid having a soccer game. Again, that goes along with just being interested in who they are and helping them. But those things can help build that relationship. Those little details there. And they'll come back because they like being around you. Yeah, part of being a good person. Yeah.

Beau Beard (07:17.56)

feel like mine is going to be the exact same.

Beau Beard (07:24.786)

I really don't have anything else to add to that. mean, that's the word. Next one. Next one. We don't all have to answer. Yeah, that's totally fine. Somebody kills it. Go for it. All right. Here's one that was inspired by seeing Bo treat some patients recently. So when a patient presents with a complicated history and multiple unsuccessful, you could say, interventions from other providers.

What is your process for untangling the narrative and beliefs that the patient may be currently maintaining?

Beau Beard (08:01.87)

I think like three things. Do you address it at all? Or I guess when do you address it and care? I would be the first thing. It's like I said, you don't know some of the people that say they say somebody literally hurt them. You still don't know if they have a relationship with that person outside of like clinic, like are they a family friend or something? I mean, that's happened all the time. then, and they'll even kind of say, but you know, that's okay or whatever. And you're like, so.

A, don't, again, being a good person, wouldn't bash anybody. You can bash what they're doing. So that's the same kind of concept as I don't, I might absolutely think your idea is idiotic. That doesn't mean I think you're an idiot. Those are two wildly different things because your idea is different than you as a person. You might be like, think unicorn should, I don't know, run for Senate or something. I'm like, well, you're an idiot. No, that's not true. That idea is idiotic, right? So I think you can.

kind of tear down, I'm saying tear down, that sounds negative, but like what was done if you're like, man, that's not good, which you saw in a case the other day, was like, that's, that was abysmal. Like that's negligent. That's what I'm saying. I didn't say, I never said that person's, I said that is negligent. What they did, right? I'm not saying them and that's two different things. I'm not saying that's their whole practice. So it gets, if it's negative and this becomes the narrative they were told and you have to untangle it because of something you need to treat, right? And that's where it gets tough.

You've got, mean, we had a guy the other day comes in long-term patient cervical MRI. saw him long time ago. I've talked about on the podcast a long time ago, a lumbar MRI that said he was signed up for surgery two weeks out from seeing me. We talked to him, no repeatable findings. None of this. have the whole chronic pain talk canceled surgery never has or cancer never has any of that. comes in to bulging disc my neck. I'm like, I thought you'd be the last person to listen to those MRI findings.

wasn't even close on what was going on that had any relation with those cervical discs. And I'm like, but I didn't say anything about the practitioner, but I just, needed to say, that's not what you're dealing with. It's this. And then I explained to him how, he was like, why didn't they say that? I was like, I don't know. So you basically, think the best way is to defuse what they were told by not directly addressing it and be like, does this make sense to you? And they're like, yeah, well, everything else that are told then falls to, you fallacy. So that's one. And then let's say something was actually like bad.

Beau Beard (10:20.066)

like somebody did get severely hurt or something and they didn't address it appropriately, part of that's on you as a clinician. mean, that's in our bylaws, right? If somebody was like severely negligent, did something wrong, I mean, at some point you kind of say, well, hey, I'm a clinician. have, you know, responsibilities to the board, you know, whether it's, you know, reporting an MD to the medical board or chiropractor to the chiropractor board, you kind of got to be like, well, did you address this? No.

We don't want them to do that somebody else. So mean, it's to like what level all the way from, I'm kind of being mean here, but a dumb dumb telling somebody they got degenerative disc disease in the worst spine of their life. And you're like, oh, whatever. Like I don't care about that anymore. Versus you need your Achilles cut in half and you're a 14 year old and we need surgery. And you're like, excuse me?

You know, stuff like that. So it's the degree of the severity of what they're told and then how much do you even need to address it for what you need to get done. Sometimes you don't need it all. It doesn't matter at all. And then you approach the topic and it's an absolute train wreck for you. Especially early in your career, because you're going to try to explain way more. And then you get yourself in trouble of, let's say it doesn't work. You go through your trial at Carey, you just told them what they were told was wrong. You told them something complete opposite. You go through six, eight visits and you fail too.

you, I guarantee they never come back. Because they're like, who was right? Obviously not you either. So you got to kind of, again, that's why you paint all the pictures. mean, so we had a person here the other day, in a panel, I mean, there's a case up there that we'll be presenting, had a DVT, got checked out, they told her she was fine. She comes in, I was like, it doesn't seem like you do, but I can't also say you don't. You know, don't have a Doppler Ultrasound. I was like, so I'm not gonna do any these treatments. But I was like, I don't know.

I mean, I literally left it at that, but I painted all the options around it. And she like thanked me at the end. And I literally don't think I did anything for besides like explain the scenario, what she should do next, the options. Um, yeah. So, and I mean, I didn't know, I'm being honest. So like, but I didn't tell her, Hey, it's not a DVT. And then she literally went to her OB later that day and they're like, Oh, it is a DVT. I mean, I would look like an idiot. You know, so like all the options, but not, I'm going to say this and it's going to be like, I'm talking about this, but you have to be confident in all those options.

Beau Beard (12:41.678)

It's not like you're like, don't know, so it could be anything. What are you saying? You're like, this is the possibilities. are the options to lay it all out. She was definitely grateful for you taking the time to explain. again, sometimes you can lay out all the options. You didn't see that option that it was, or you laid it all out and they still didn't buy your spiel. Like that's fine. But you do your best to educate to the level that you need to. That'd be my thing. Yeah. Anything to add on that?

the guy, the new patient that was earlier this week that we talked about with the shoulder that had multiple complaints, mostly he had been talking about the shoulder when he described it generally across couldn't pinpoint, but had really limited how much he was doing to the point of not working out for a long time. So I told him and tried to prove to him on tests that I said, Hey, these things are going to check the integrity of your rotator cuff, your labrum, the things that you're worried about.

injured and if they don't hurt and they're fully strong we can be pretty confident that they're not you know an issue and they were and so then we ended up testing things that he had complained about not being able to pull ups push ups all that stuff so we looked at them he didn't have pain doing them now he was kind of weak doing it but he hadn't done that for quite a while so once he saw that those things were oh there's no weakness here this doesn't hurt he

He doesn't have the same understanding about what those tests are as we do, but I tried to explain that to him. That, hey, these things are not, there's no weakness here. There's not even pain doing these tests. And then showed him, hey, this looks like a push-up. This looks like a pull-up. Yeah, no, it's good. think it's a common one that I kind of have had experiences with in the student clinic at Parker. It's like, it doesn't mean that it's bad thing.

So I heard this the other day that Netflix, the executives at Netflix are now telling directors and producers to create what they call, oh God, what is it called? Scrolling movies and shows. So movies you would watch while you're on your phone. So they want the plot to be so, the actors are literally gonna tell you, to save the world I'm gonna have to go into space and live on Mars for three months and then the,

Beau Beard (15:04.226)

the protagonist would be like, are you sure you could do that? And he'd like, yeah, my, you know, take me like, they literally gonna tell you exactly everything. But if you watch that not being on your phone, you'd like, this is worst movie I've ever seen in my life because you don't want to know everything. That's the same thing as a patient. They don't want you to tell them everything you think they do. What you're doing is trying to set up like the biggest points and then they come to the conclusion of like, what I was told was not right. Or, hey, what you're telling me makes sense to me rather than we over explain like,

this test is showing that, this test is showing this, this test. They will, like Alex said, they will never understand that. You're trying to lay it out so they're like, oh, yeah, totally. Like, whoa, why was I thinking it was that or why were we working on that or why didn't we address this? Kind of helping them put the Yeah, it's a good book or a good movie. You're like, oh, okay, I get it. Rather than like, hey, here it is. And then they're like, again, what if you're wrong? Well, that's not your conclusion, right? If they, and here's the crazy thing. Say you.

Say you fail at care and you set it up where you have this implicit or intrinsic buy-in, right? Through that storytelling, you're still going to keep people around more often, right? Because they feel like it's a partnership because they had to work with you on your treatment and the framework rather than you just like, this is what we do in here. Here's your 12 visits and let's get rolling. Oh, it didn't work. That's how it goes sometimes. We can't help everybody. I mean, that's just, yeah. And that's what a lot of places are. mean, from MD to us to whatever.

Yeah. Yeah. I like that. Good partnership. Yeah. Cool. Anything else or next one? Roll. Let's roll. We should have brought, oh, we should have brought the button for next question. I need to get rid of that. We can go grab it real quick. All right. Next question comes from the one and only now Dr. Trent McCune. Oh man. Yeah. He asks, what differences are there between how you practice in your first year?

and how you practice now. So you're how many years in? Almost two. So you answer it because that's a better, it's honestly probably a better question for you. Yeah.

Beau Beard (17:17.486)

I think it goes back to what you mentioned about like you're gonna try and practice exactly like maybe how your mentors were or what you were taught like at seminars. And I think sometimes you have to, you've gotta do care in my opinion, like almost how you would want it somewhat kind of done to you. Like he may want treatment.

different than how I would like treatment. I would say like the soft skills, I guess, of like just some like soft tissue, like to me goes a decent ways for the patient, which I was like very, I guess like my first year I was like, I'm not gonna do very much of that. We're gonna do like, we're gonna do some exercise. we're like, this is what this clinic does. Whereas sometimes it's like, you know, like that might be good, but you may need to do a little bit of like,

I don't know, a little bit if you want to call it stretching or a little bit of like vibration tool or a little bit of dry needling to a muscle just to get it to calm down because the patient feels better afterwards and then you get some buy-in that way instead of being like I'm gonna get buy-in because we do things different because I think that still can be different, right? Because you're allowing, you're still controlling that case a little bit fully in my opinion but you're also like again like it's patient dependent.

Right? Like what has worked in the past? What hasn't worked in the, like what hasn't worked? Yeah. I think that's, I think that's like my biggest thing is don't neglect like how far some of your soft skills can actually go. That's probably one way that I think I have, I've changed along with also not holding myself. I say this, this, this might be like a weird way to put this, but feeling like everybody has to get better in six visits. That is like one thing that I think

like stressed me out like at the beginning of my career was like, like six visits, they have to start feeling better, right? And if they don't, I'm doing something completely wrong. Whereas like me and Beau have talked about, it's like, you sometimes like these things have been going on for years. So to say that you're gonna like fully make a change or they're gonna be completely better in a hundred percent after six visits is just pretty wild. Yeah. I was curious on clarifying when you say better, do you feel like in six visits they need to be completely?

Beau Beard (19:43.64)

Like six visits, like in my opinion, I was like six visits, they better be looking at like getting out of this office type, like spacing things out versus like, dude, we could be 10 visits in and it's like, hey, we're starting to make some actual change now because you've had this thing going on for so long, right? And that depends on what they're doing outside of here as well. Cause that's the other pieces. It's like, you you feel like you should be making more progress inside the clinic, but then sometimes that comes down to like, well, what kind of person are they? Are they like doing their stuff outside of here? Are they not?

And then being like, hey, this is, if we're not going to do stuff outside of here, like this is, this is what care is going to kind of look like. It's just going to take longer, right? Not being like, you have to be like, they're not doing their stuff. Well, six visits, let's go ahead and start spacing out when they're not getting any better. or being like, Hey, maybe we just need to like flip what we're doing because we have ran down that path. And like, we have ruled that out. Like, here's the other options that like you said, you painted a narrative and you laid those things out. So that way they're not just like caught off guard being like, well, why did we all of sudden flip?

What about you? What's different? What's different from like your for you guys early in practice versus now? He said like first year versus now, but like since you guys are a couple years like.

Beau Beard (20:57.902)

That was a big one for me was, and I, and I think patient visit average probably reflects that too. Cause at the beginning, even if you looked on our dashboard on Jane, the number of visits per trial of care was lower than it is now. you think in a quick way, do you think that's your expectation of what is realistic for what they're actually dealing with or your ability to get by and, all this stuff we just talked about? I'm just curious. It's probably both. Right.

Cause your buy-in is probably based on your expectation, which we've talked about a lot is like, what do you actually think they need? Like kind of like Clay talked about of like, get the money and the timeline out of your mind. Like, what do you think they need? That's that is literally your responsibility, not well, insurance cover, what can they afford? So I read an interesting thing and blink by Malcolm Gladwell last night. He was talking about these, harding errors. So there's this harding test basically saying like,

I see Troy walk into this room, a white guy, clean cut. I see a black male walk in, same age, could be the exact same clothes. My mind is literally doing subconscious like thinking. So let's say they both come in to buy a car, like they proved this. Car salesman will offer the same car for about $1,500 more to the black guy.

Cause they call them a lay down. Like they think in their mind, they'll pay a full price versus for whatever reason. And then this like, you know, just white guy is going to like haggle or whatever. So we're just going to start lower. So there's all these things. I think also, when you look at that kind of stuff, you start thinking in your mind, like, well, I don't look at every case like that. You literally look at exactly what they need regardless of them or me. Like Seth said, like, well, I would like this, but

you know, so I'm going to paint it's my perspective, you're giving yourself so it's your brand, but like you're and that's where like if it's off brand for you, and that's a weird way to put it, like what this person wants, right, versus maybe what they need with the mix of what I think I want to give them. And you're like, this is way off. That's where you should be like, no, well, that's a different person in your office or altogether. Like this is not a fit because it's just like that's at the end of the day, it's your career. Your job isn't to help everybody. It's to help as many people as it can. And if that's just like somebody that

Beau Beard (23:14.702)

drives you up the wall or something, be like, dude, why don't you go over here? Now you got to figure out a nice way to tell them. It's like telling somebody they got a nugget of a sweater and you're like, yeah, it's just not for me. I don't know. think that's a good, from what I've seen in you, I think your buy-in of what you think's going on with them will lead to more visits, not in a bad way for people listening, like more visits, like yeah, like necessitated more visits. I'd say that's been the biggest change and something we've talked about a lot of like.

Do you think they need more? Is this enough? Are they making change? Like all the stuff Seth said, but maybe it's been a different thing. He's like, I expect perfection in six. And you're like, I just think that that's not maybe the best thing for him. It's kind of what I think upfront. You're like, oh, they've been in here for visits. Does that make sense? More of a benign altruistic thing where Seth put it on him, you put it on them.

Like I don't think they should keep coming in because they might not be able to afford it or time and stuff. like, I should've gotten better in six. There's probably a little bit of both there, but I saw Kathy Dooley put up this morning, the quote by Salvador Salvador Dali of have no fear of perfection. You'll never reach it. That's like every patient that walks through anybody's door ever. Like whatever your goal is. mean, nobody is ever like, Oh yeah, that's perfect. Exactly what I thought. Top tier house for May, all the functional health stuff they left a hundred percent better.

Good luck. But that's what you're trying to do. That's what Brett says all the time, right? That's your goal. Never happens. I think coming to terms with that for specific kinds of patients has gotten better. Like I think of a lady who, what, probably several weeks ago, I mean, such a long medical history that it was like 14 pages when we got the vaccine. And

If that would have, if she would have walked in like the first few months that I was practicing, I think I would have felt bad for her not getting fully better, even though she's been in pain for 45 years, has all these other comorbidities. And I think we worked together for four visits, five visits. I would have loved to work together a lot longer than that. but now I realized like, okay, even though she may have really liked how different this care was, she's still not going to do.

Beau Beard (25:35.756)

Yeah, that's her. yeah, it's always been a revolving door of practitioners over the years, which I would have loved to put that to an end. And that's kind of if you're competitive, that will be a positive or negative sometimes like, nobody's been able to get her to like get better from that. But also nobody's been able to like get her to do stuff. So then you're like, yeah, we can do it. it's like,

Sometimes you gotta like see the writing on the wall and be like, okay, I'm not stereotyping, but I just literally took three visits and you're like, yeah, I'm not gonna do those exercises. What did the expectation is? No change. Like, yeah. And at the end of the day, I think she kept doing one of them and she, know, one of the biggest things for her was like being able to reach behind her and she can do that now. somebody go into the dentist that doesn't brush her teeth and they're like, you're gonna brush your teeth? And I was sure you're like, okay, see you. Cool. I would have loved for her.

get out and start walking every day or doing some more than what she's doing now. Yeah. Yeah. I think just kind of hopefully maybe wrap this question up, but I guess, I guess like just as of lately in the last like few months, I think it you as a new clinician, like you go through waves of like you're on like a high where you're like, I'm doing really well. And then you can hit some absolute like pits where you're like, yeah, where you're like,

I am a pretty terrible clinician just in general. And I think some of that is reflected just because again, like I'm almost two years in, not like I have like a long standing career to talk off of, but I've had some more complex cases that have come in because patients have referred their friends in and they're like, yeah, this person's, know, been going to here, here, here and here. And so what I saw at the beginning was right, I held it on myself of like, hey, I've got six to eight visits and they better be better.

versus now I have like a more complex and like since I've seen them more, it starts just making me feel like, man, I'm not that great of a clinician because I'm not getting them better in this. And I think that like that confidence still needs to remain high even though it's just like, to me, I don't feel like the...

Beau Beard (27:43.054)

In my head, originally, I was like, the better clinician I am, the faster someone gets better. Whereas that may not be the case, right? It might be like, hey, like you might be doing fantastic because it maybe took, you know, maybe twice as long as what you thought in your head that it was going to be, but doesn't mean that it was what they didn't need. Yeah, that's been like a, I think- If you didn't have thoughts that you sucked, you never get better. like, and there are, in every profession, there are people that are like, I'm the best in the world. like, not for very long.

I've definitely sat in bed being like, dude, I can't believe people show back up. I'll be 100 % honest. You just sit there and you're just like, you go through your nose like we've done before and you're like, well, they said they felt the same, worse, worse, and that's three in a row. you're like, well, here, I'll answer my quick one that builds off that. I used to think that way. Oh, they're no better. They're no better. Now it's shifted way far away. I still have that feeling.

of, they're telling me they know better. It's no changing. I can't figure it out. So like, this is my thing. So even when people are literally like 80 % better, and they're like, yeah, I'm running and doing their thing. And there are things I expected to change, right? Or like 100 % was my expectation. It's not me saying I didn't get them better. Because I mean, they'll tell me all day, like, better or whatever. And I'm like, I'm not figuring out this other aspect.

And that starts to like, that's where for me, it's to me, it's still like, oh, I suck. It's like, why can't I get that to change? Why can't I figure this part out? Why? Like I lay out a whole narrative that I'm like, this is like bulletproof and it's like, yeah, I'm gonna take this medication over here. I'm like, what are you doing? And like, so like, for me, it's less of what they're telling me and the pain and the feedback and more of, I expect myself to be able to figure this stuff out. And I think that's.

I think most people that are going to be really good in any profession, turns into that again of like the game within the game of like, it's not the, I saw Nick saving the other day. It's not the result, right? To process. So then it's that process of like, how would I get better now that people are getting better? Like a lot of people are like, yeah, I'm good. Like, and it's just not my good, you know? So I think you just like, yeah, you have your kind of echelons. Yeah. I love it. Yeah. Actually quick follow up to that discussion when you're having that dialogue with the patient about like the,

Beau Beard (30:06.03)

setting expectations for the duration of care. What does it look like? Is it like, okay, set a game plan early on, or is it that and just kind of having those touch points along the way, like, hey, this is where you're at. This is figuring this out, that out. They kind of, I guess just brief, I know we've exhausted this topic, but I just wanted to shine a light on that dialogue really briefly at the end of this question. I I always tell them, we all.

Hopefully do somewhat the same thing. in terms of like the prognosis visits, huge of determining what it's actually going to look like. But then every visit is prognostic. Like it's just like you're cleaning it up or you're getting farther away from no one knows what's going on, which is going to happen. That you're like nuts, you know, hopefully not not knowing, but you're like, Hey, all those options that are unexplored or possibilities. that's what we got to refer out for get imaging to explore those now, but like,

I think second, third visit, which you guys have all heard me say before, you should be able to paint a really, really clear picture. I don't think first visit, you can give them an idea. like, hey, next visit, if it goes this way, it's probably going to take XYZ. You can say that. That's what I'm saying. Second visit, it went this way. can expect, now I'm going to clean that up a little bit. So maybe I'm just using an example. I'm going say, hey, I'm going to see twice a week for three weeks. Then I'll do one week and I'll skip a week and I won't go to a month. That's very common for me to say, but I'd say it on the second visit. Say I get six more visits in, stuff's just not changing.

Shoulder range motion not changing, they're still having pain with the same stuff. I would hope we would all, or all clinicians would address that point. Hey, all that stuff I said, like, I don't want to keep you in here forever, but like this thing's just not changing fast. And you know, I don't know if that's fully on me or not doing what we need to do at home. And then you got to get those answers. If they're like, I'm doing all my stuff at home, you're picking the wrong stuff, right? You're doing stuff and here you see massive change. And then you see them coming back telling you to do an exercise. they're not. So you gotta like, again, you're trying to figure out.

actual what's going on, then you gotta paint the realistic picture, right? Not the one that makes you have the most money and not the one that makes you feel good, oh, I got them out here soon enough, but literally like, this isn't changing, oh, this is faster. And you should also be on that. Like somebody comes in with a low back pain, thinking of our low back guy, know, patient sent him in, his mom sent him in. I mean, I can't even say this, it's pretty easy. I mean, it is pretty easy. There's probably a of stuff to work on, but it's like.

Beau Beard (32:26.222)

I even told him, go, hey, one or two more visits, like I'm gonna let you around with this stuff. Just kind of see how it goes. That'd be four visits. Could I see him way more? Yeah, but like, it's not, you're trying to also, I think a big thing for me is what is that person's life like? So that's a college student that's gonna be going back to college and like, he's not gonna come back from Auburn or every break like, hey, I mean, maybe.

But like, think you're also trying to lay out such a good plan for them that they're like, I do want to come back more than you've even told me. And then your job is kind of like, well, you don't need to, or if you want to, cool. Or, Hey, I'm going to give you options around that. Right. But I'm not having to force them into like, Hey, I need to see more. Yeah. Love it. Alrighty. Moving on. This is a question from Ethan Holm relating, uh, relating to neurodynamics.

He says, if you suspect nerve irritation, what are the best strategies you use to treat the nerve and the surrounding structures without treating the nerve with sliders and tensioners? Follow up to this question, this two part question. When you do choose to use sliders and tensioners, in what scenarios do you use them most often?

The first part. Tough second part question. I mean, that's like, How are you treating nerves without? Without actually mobilizing or tensioning the nerve.

So here's how I'll answer this question. I'll let you guys take the other part. I don't think you're ever treating one thing. That's what I'm going to say. So like if we said, so we have our little rubric that we kind of think of like, it's, you know, MSK, which means like tissue peripheral nervous system central, and then some sort of like functional medicine overlier. That's the biggest thing. That's how it plays. So say, you know, now we're saying, it's peripheral nerve, right? Motor sensory, cutaneous, whatever. And they're like, that's what I'm treating.

Beau Beard (34:23.842)

Well, first you're telling me you're just treating pain, right? So that would be a pain alleviating maneuver, all of those things, right? Because then if we ask the question of, we get to the second part of when to use sliders and tensioners, let's just like McKenzie, when do you use overpressure? When do you do under range loading to do what? Get rid of pain. Doesn't tell you why that nerve was irritated or whatever, entrapped or this, that or the other. So this qualia around it, which would be...

you're treating a bunch of things, which one is the most important? Yeah, you want to get people out of pain so they don't move different and they're happy and you get by and all that stuff. But then the next thing is, well, what do you do after that? Which probably buys leads into what are you doing to work on that nerve, which is why is it irritated in the first place? Yeah. Yeah, I that. But then we have a bunch of tools. mean, we do stuff all the time. mean, stacco, cupping, taping, I mean, all of these things. So that's again,

I keep, I'm sound like a commercial when I try to teach like art of assessment, it's saying, again, you don't, didn't have any of those tools. I mean, I didn't take, you know, dermal traction until like five years ago. didn't take, you know, cupping wasn't near as like popular. didn't even have cups when we opened. Like it's all these things that we'd say, Oh, this is what you do for peripheral, like stecho cupping, um, uh, DTM, like none of that. didn't have any of that. So like, what'd you do for cutaneous nerve stuff?

Well, we didn't even, mean, it's stupid as it sounds. Nobody was taught like Diane Jacobs talking about skin rolling and, know, uh, dermoneuro modulation, all that stuff. It was like, what do we do? We did other stuff to calm it down.

I didn't know it was so easy that I could just like find a cutaneous nerve. I mean, it sounds stupid. And then you're like, oh man, what you guys are idiots back then. And we did ART and you're like, but why do we have those tools? Because you got more specific with your diagnosis. So, oh, cutaneous nerves are irritated. You can calm down that pain. Why is it irritated? Why is that irritated? Why is that myofascial entrapment there? Complained to a functional medicine, they're chronically dehydrated. It's how they said it worked. It's the activity to do. And pretty soon you're not back to just like, the nerve, the...

Beau Beard (36:28.3)

lateral foraminal stenosis, the postural intra-abdominal pressure. It's like all of these things at once. And then that leads right back to what we said with the treatment plan. What's real is like expectation besides just yapping and they're out of pain. You're like, maybe, you know, sometimes it is that, like, you're out of pain. You're doing pretty good. We're not looking too specific on how you're on or anything like see ya or it's not. And then that's why you need a lot of tools. I say need.

It's good to have a lot of tools. So then when that need arises based on what you find, you're like, oh, I can do this and play around with it. But then it becomes diagnostic. I did this thing, it didn't work. Did this thing, it didn't work. Hopefully that's not your first choice to just start doing stuff to decrease pain. mean, nightmare. That'd be my answer. Yeah. That's a good answer. Yeah. The biggest part of that is just not, you wouldn't necessarily even have to have neurodynamics if you, because you're trying to address the thing that is causing that nerve irritated in the first place.

Yeah, if you didn't have cups and didn't have dermal traction before you were you were working on the thing that led to that nerve being irritated. Like nerve neurodynamics when I got out of school was mainly like Butler's work, right? Like like the nerve we did the other day with the plate, right? Like these kind of exercises to take people through these full like nerve moves, right? Radial nerves bands like going in these big movements. So then unless you guys want to tackle it, I'll try to answer the question of the specifics of when you use it.

of tensioners, sliders could fit right back into that paradigm. What's going on? Obviously that's the diagnostic part of it. You and I have talked about this a lot, point to Troy here because we kind of bring up, know, you've went and take, taken some courses where they're heavy in this, you know, these kinds of fields. My take on a lot of this stuff is, and this just, I love Michael Shacklock. I think neurodynamics becomes a dermal traction.

To me, that's all it is. And when I say that's all it is, I'm not discounting it. Because a lot of people say, if you don't know how to do neurodynamics at a high level, you're going to miss some opportunities to remove pain. That's my take on it. People might say I'm wrong. It's no different, and I know Peter McKenzie will try to somehow throw a knife through the internet at me. It's no different with that. You can't sell me that if you do two days of

Beau Beard (38:49.326)

cobras every hour and then when you're in the clinic you're doing overpressure and you see them four times and their pain's completely abolished and let's say it was ridiculous in nature and all that stuff, that that's the end of care. So that that tool is all encompassing for that thing. Why do they have derangement? Is it motor control? Like why did that thing happen in the first place? And I think a lot of people just rest on, well we don't know. So just kind of abolish the pain, normalize the stuff. like, I just don't think that happens. Does that make sense? So I think you're using those.

when you find doesn't need tension, doesn't need sliding, how, based on the diagnostic process that Michael Shacklock teaches, your other hands-on palpation of does it move, the tissue glide, how's the joint move? But then you could say, well, if I'm trying to fit, when do you use that? It's no different than when do you adjust somebody? When there's a joint restriction. So when would you use a tensioner?

When I think the nerve can move well enough and is not irritated enough that attention is going to make it worse and tensioning actually creates some sort of like tolerance of that nerve being stretched. So you literally can answer your own question if you play the diagnostics right. All right. And then the shacklock literally spells out very clearly when you shouldn't. So like it's kind of self-explanatory, but this is Brett Winchester makes this point all the time. What says people are swimming in information and dying for integration or application.

They have no clue how to use this stuff. I don't think that's a methodological issue. I don't think that's going and taking another course and learning how to do it. It's learning how to apply it within diagnostics. That's the missing thing. like, don't know when to do it. You're not going to go take another neurodynamic course and figure it out because Shackle could tell you it is or isn't. So when are you going to know? When it is. What are you going to do when it isn't? All the other stuff. That's not what people want to hear, but that's the truth. That's right there. Anything to add or?

And that makes it sound hard. It is hard. I mean, that's what we just said. You get kicked in the teeth, feel like you're an idiot, all that stuff. But it's also wouldn't be very, to me, it wouldn't be very much fun if like, we're like, I got this gold standard. If you can adjust, do neurodynamics, do McKinsey, do DNS, and there's this protocol for every little thing they come in. I literally wouldn't work. I would literally hire a bunch of like chiropractic assistants and be like, here's our protocols. I wouldn't want to do that. reason I don't want to do post-op PT. There might be slight nuances, but it's

Beau Beard (41:09.486)

pretty, hey, this is what you should do week one, this is what you should do week two, all the way up to week 12, that would be so boring, I'd pull my hair off. Yeah. Yeah, it's exciting what we get to do. All right, next question here. Can you describe a specific clinical pivot point you took in a recent case when you had to change the direction of care or significantly progress the intervention strategy?

intervention strategy where you had to pivot. Sorry, I just choked up on my words over here.

Beau Beard (41:43.853)

and

Beau Beard (42:04.43)

I mean, is that one of your questions? here, I mean, you've been in a lot of these cases. I don't think there should ever be major pivot. Now, a pivot that you laid out and you took it, cool. If there's like a landmine, that's like your fault. And I would hope that happens less and less. It's going to happen a lot earlier, right? Like, ooh, they went, the worst ones are what? They go to somebody else and they find something you either said wasn't existent or you didn't even mention. That's going be the worst things ever.

Right? Hey, I went to a PT. They thought it was, I needed nerve sliders. They did a nerve slider. All my pain was gone. And you had just said, well, Shackalock says we shouldn't do this upfront because when something's hyper irritated, that's probably the worst thing to do for it. And you're like, son of a bitch. Stuff like that. You miss it you didn't talk about it. But the big pivots you have to take are where he never wants you on the thing. And it was like our Highlands game athlete. Like he didn't want to have surgery on his shoulder. I didn't want him to. He was trying to compete.

I literally sent him for a, what I would thought, I thought would be a non-surgical consult to rule out surgery because he was so adamant he didn't want surgery, you know, having surgery. So what was the pivot there? I'm still not a hundred percent convinced he needed it, right? But at the same token, like he wasn't getting any better with me. That's why I sent him. So it's like, what was the option?

I was going to try to get him to have some sort of pain mitigation and come back in rehab, but like that might not have worked either. So let's say we did that. I mean, then into what is it? Just take time off the surgery. I think the big pivots are like, you think you have it all laid out and it's like, God, this stuff's just not working. And that can wear it's tough because you could still have all the options and like you just keep running up against it. Yeah. Another one. So, somebody that came in with neck.

something I could basically like lay her down, turn her head full range motion. She'd sit back up after every visit. Range motion locked up pain. There were lot of pivots in there and she threw them at me. Hey, what do you think about an up-dero? Hey, what do you think about this? What do think about that? And I sometimes I don't think that's a idea and sometimes it wouldn't be. So we ended up sending her out for trigger point injections, which I told her from the beginning. That's what I wanted her try to do, you know, conjunctively with what the Karen biggest change for.

Beau Beard (44:21.55)

But that took me nine, 10 visits to get there because of all the other like pivots that she wanted to take. And then I wanted to create a partnership. I'm like, no, don't do it. So I think that she wouldn't come back. maybe her biggest pivot was me managing different rather than like decisions on what to do. Yeah. Which can be huge. Yeah. Like, I'm not going to say no, I'm just going go. Okay. Let's see. Yeah. I've definitely seen you navigate that management a lot lately. Yeah. Yeah. It's been, Yeah. Can you guys think of anything?

I got it.

he had prior to seeing me had an acute flare of disco genital back pain, after starting getting into a routine, a workout routine, which was probably way too hard, too much too often. and got better, got worse, started seeing me got better over the course of eight visits and was doing good back to workouts, but was always very hypervigilant about, I just don't, you know,

I like I'm just going to tweak it again, that kind of thing. Well, he, he tweaks it again, picking his son up. He emailed me over the weekend about getting, he wanted to get an MRI and I had told him previously, we can get an MRI. This is early on in care. And it's going to show that you have a disc bulge herniation, but you know, there's a good chance we can treat this conservatively, which it was, we did. but

for him to appease the fact that he's always kind of worried about this, but he also is like, Adam and I just, you know, wanting an image. I told him, I we're going to see what we expected to see on the image. We will order the image. So we the image, shows us what we saw, what we expected to see. And then getting, you know, he, from the beginning, said he didn't want to have an injection or want to have steroid or didn't want to have surgery, which I told him, said, if we get that, it would be because what we're doing,

Beau Beard (46:24.782)

is not enough and we need to do something additional, which would either be an injection or a surgical nonce. We ended up doing a steroid pack, which was helpful prior to doing those other two things, but they're not completely off the table. He's doing a little bit better, at first, I think early on, I would have been like, no, we don't need to get the image because you got better. And I know that's frustrating that you had a flare up, but like we've shown that you can get you better. You can get you better again.

Whereas, you know, he's frustrated that it's happened again. He's got work stressors going on and he just wants to get the image and there's no harm in getting the image because we're going to see what we expect you to see. So we did it. And I think I'm not even if he didn't learning lesson for you. So I mean, I've had, I've had images where stuff pulled up and told him it wasn't that or I didn't explain that. You're like, Oh, that's a learning lesson for you. Like either be better, right. Your diagnostics or always again, like

leave the optionality open up. I don't know exact without it. So I think that's something I've learned too. It's like, don't be absolute, you know, with the imaging thing, like, those imaging findings don't mean anything or, that's not going to be on there. Or even if that was there, that doesn't matter. Right. So I've said a lot of stuff like that and you gotta be careful. It could have been big enough that they just said, we should, we should do surgery on this now and it's going to be a good outcome. granted, I didn't want to do that at the beginning because you see that and hear that from other people that

They went straight to the surgery and it wasn't necessarily the best thing. But I tell people when I have sent people out, the two or three that have had surgery have had good outcomes because they exhausted their care, know, trial and care first.

So yeah, that's probably the most recent. Let's hit Troy with a question real quick. Yeah. If you could start this internship over, I it could be one thing, it be a couple of things. What would you do different? Like, how would you approach the internship different?

Beau Beard (48:20.654)

That's a good question. How I would approach it different. I would say.

Probably just being more vocal and like within the treatment room itself. I know it's just kind of, I've been here to shadow before, so I know all y'all and I've got to experience all with treating patients before. But there's been times where I walk out of a patient encounter when I was like, man, like I'm curious about this or that. And I think it's like past experiences with other providers where I guess you're more so like,

conditioned almost to just be there, right? But this is a different experience because A, like y'all are different and this is such a long-term experience for me too. I think early on, I think, you know, as I got more, I guess comfortable with the patients here in general too, it's when I, you know, we got to have a lot of those conversations in the, you know, in the office getting to get in the nuances of neurodynamics or directional preference or different things on my mind that I, you know, got to see y'all do.

I think early on being more direct and open with questions right off the rip rather than just, okay, let me get a feel of how this patient care goes. Because again, I was just kind of toying the line. I don't want to like overstep, but I also want to get the most out of this experience as I can. And I know all of y'all, if I ever did anything that was like, you know, a little bit too much, A, we're all adults and you know, we can have a discussion if that needed to happen. But I don't think I would have ever

done anything that would have been quote unquote too much per se. So that would be probably my answer to. think that's a really good point because we, I mean, we do, we personally tell people like, don't have conversations. I mean, we want you to talk to the patient stuff. We don't always just like stand in the corner sheepishly. Yeah. But we don't want to interrupt care, like slow somebody down. But at the same token, I think it's really beneficial sometimes if you're like, Hey, why wouldn't we, or, you know, you got to frame the questions, right? Obviously like, what do we ever look at this or what about that?

Beau Beard (50:23.81)

Like it might be something that literally they're just like, I didn't think about that. Or I forgot, like that was in my mind. Or also like it brings it up to the patient a way that like it creates such, that's what I've told you, you've heard me say numerous times, like it's a better patient experience when there's a shadow intern in there because I can talk to you, feed them educational stuff as a by-product that I would never tell them. So it's like a win-win all across the time I'll say what? is for you. Well, kinda.

Yeah, pay attention to this and then I don't have to explain the the create. Hey, this trophedema thing. then, you know, that patient's like, what is this? And I'm like, this means this. But I wasn't like, hey, see this stuff. And they're like, why tell me this? Yeah. So there you take the high level education, which is what we've always tried to with like YouTube, like speak on a level that like for you, you would learn something. But then as a patient, they're like, I still understand it. That's because they're going to get fed stuff that's either right, wrong or this, that or the other at that level in a

clinical room outside of here. So it's like that I think is our responsibility not just be like, Hey, this is your muscle here and we're going to rub it. And that's, think that's idiotic. Yeah. I think that's a really good point. Do you guys have any questions for him? I'll hit another one if not. Yeah.

Okay, so Seth and I have been trying to culture Troy and the ways of cinema. So what has been your favorite? Now, this is preemptive because we're going to watch a pretty fantastic movie on Saturday night. What are you guys watching? The Holdovers. I've never seen that one. It came out two years ago, my new favorite Christmas movie. But what has been your favorite movie that you've watched with us and why?

I would say Dune 2 takes the cake. Had you seen Dune 1 before? We watched it you here. So it was, Dune 1 was a pretty slow movie building up. Even though Dune 2 is longer though, isn't it? Yeah, it's longer. It's more action packed. I agree. But it was just good. Not too long ago. Yeah, they really well done. What was that movie you mentioned the other day? With which one? It was a comedy.

Beau Beard (52:41.518)

I'm trying to remember who was in it. I think it was literally yesterday.

You were talking to Bridget and you said this is something that Ricky Stanicki. Yes, Ricky. Very John Cena, Zac Efron, Zac Efron's business buddy. I can't remember who it is. It's hilarious. So Sloan picked it. We were just one of those like she's cruising through. So Sloan's notorious for just she'll look for something to watch so long. I'm not gonna watch anything anymore. 45 minutes later. So literally she went through a couple of things. pulled out.

Wow, come on. Hilarious. Absolutely hilarious. So anybody out there listening, it's a little dirty comedy, but it's funny. all get out. So add that to your list. That actually made it easier because I have a list and I just said, hey Troy, I know you haven't any of these movies. one. I was definitely cultured quite a bit with movies. I got one more question for you. We've got time for anything else here. So what are...

And if you want to do both or if you only want so what are one or two specific things that we do here that you will either for sure implement and your practice out or change or leave out. Okay. Implement it, change, or leave out. Maybe try to do one of each. So get it. So similar to what Seth mentioned earlier with kind of the soft tissue side of things, like at the Parker clinic and coming out of there, I'm like, I don't need to do any soft tissue work to

change the quality of the tissue or you know abolish the trigger point things like that I could just load them up in a DNS position you know move them through controlled range of motion but it has been fascinating to not only learn more about the different options when it comes to soft tissue work but also to see how the patient responds to it how they enjoy it but also just to learn about the more detailed mechanisms behind it I know you know we've gotten a nerd out a little bit on discussions about it particularly with

Beau Beard (54:43.822)

kind of stekko stuff or kapo stuff. yeah, needles, literally. I've been needling Alex like crazy. That's been fun too, because I've done one needling course, haven't needled outside of that course. So when Alex asked me to needle, I was like, yeah, yeah, I got this. But it's definitely built my confidence with the needle. And I don't love needles personally, as far as like getting stuck with them or the idea of, you know, poking other people with needles. But I definitely got comfortable with it during my time here. So that's

definitely something I'll take away is doing. What about something that you edit something you're like, I don't think I'll do that or you would change. Hmm. Hmm. Honestly, something that comes to mind is in the assessment process that a lot of, not every case obviously, but a lot of cases y'all will do gate and then kind of like a full top tier. And I'm just not as familiar with gate in general. I've never taken like a course on gate. I know.

Parker Marion DMACC had a lab on gate so I got to learn a little bit from that but honestly when I'm when I'm trying to pick up on things and you know, like y'all You know share some things that you're seeing I'm like Right, right But I think just more practice with it before I'm like actually going to feel like I can glean from it But as well as like just top-tier itself, like I don't reckon I'll do

a full top tier, but I might at some point. I don't know. I think it will be dependent on the case, but you're definitely getting things functionally that you can address with, you know, with the case. just something I hadn't done before. I would do it in, you know, the regions that were quote unquote relevant to the symptom area. But, you know, I see why you do it. And I think gay in particular is one that I would need to gain confidence in before. talked about that on here. Yeah, it's tough. Yeah, can be. Yeah.

But you know, and what's one way to get better at it is practicing it. maybe I'll shift that to something that I will implement. don't know. I think the kind of going back to your like we talked about the soft tissue. One thing that kind of like change that we've talked about is like the way our profession was before. Now, like now a lot of people are going on the train of like movement is like more needed. And I think back to when our profession was very much just like, hey, like you're going to see as many people as possible.

Beau Beard (57:05.634)

You know, in one day you're going to have five minutes, you're going to adjust and that's what you're going to do. But you hear people that are like getting better when they go in and they literally have just some ice heat, a little bit of STEM and then they get adjusted and they're like, I've never felt better in my entire life. And I'm like, so there's something to that, right? Like whether you're changing just neurology of like how they're like sensing that area or whatever it is, right? So now it's like, okay, well, what can I do to use some of those things and then pair it with like,

world-class rehab or just the rehab they need in general to improve their strategies, like what kind of difference could I make for that patient? Like that I think was a big piece where I was like against, I didn't want to be like our, like what our profession was in the past, but sometimes it's like, like they were doing some things right. Like there's something you can take away from it, right? And I don't think that doing those things, you're doing a disservice to the patient because you did some soft tissue or you used a little bit of like heat on something.

I don't think that's a bad thing. yeah. Yeah. I think another thing I'll add in that bucket too is taping. I've gotten to see you all tape a good bit and seeing it in a scoliosis case was interesting too. Seth taught me how to tape a shoulder with one case and I got to do it on a patient and they're like, wow. They felt the difference and then objectively there is some benefit to it as well.

Yeah, that's another thing I would throw in that in that mix where it's like I never expected to do but I will walk away here. Yeah, think so, which you're bringing up a really good point, which is a good way to tie this up since we're running out of time is it's one thing to go take so you could go take a rock tape class, you're rock taping. mean, you're going to walk out of that class tape all over you and feel like terrible for how much tape it's going to be really hard to connect the dots of how impactful that is on people that aren't

presenting with specific pathologies, right? People in there are like, yeah, tape my ankle, whatever, tape this, trying to be something, tape scar. But then you see somebody with like an AC joint separation, you see a scoliosis case, you see an acute ankle sprain, you see somebody with lymphedema and you're like, this stuff is wildly impactful and you're using it for a variety of reasons. and there's all sorts of courses out there, but same thing, like needling, right? You go take a needling course, you don't see how fast it can like decrease a trigger point and you're like,

Beau Beard (59:29.198)

Well, I might do that first in a lot of cases, just so there's less pain and they can move better rather than doing DNS first. And you have decision points there, seeing if it gets better and then dry needleing, it's not awesome. And then you start making decisions based on the case in front of you rather than just like, taught the course, they taught me it's for this. And then you're like, I don't really like sticking people, but I'm going to do it. Or I don't really like sticking people. So then you just like gravitate or away from it and pretty soon you're like, I don't want dry needle. You know? So I think seeing it in practice is huge. So I think that's a good.

Like said, good way to leave it because I mean, there's a lot of students that listen to this that are going to be seminar junkies and then they may start editing what they're going to do or not do without any clinical experience behind that at all. And I think that's a, it's a misstep because you, can edit right? You're like, man, I don't know if we'll be doing gate. So my, my feedback on that would be, I'm not saying those things you have to do to be world-class. Like we've hedged our exam to be like, well, this is the minimum. Like this is, you know, not the maximum.

Maximum is like, there's other things to always that you could always do. It's the minimum effective dose. Like this is necessary because it is wildly important to watch somebody move really for them, right? How do you move? Cause a lot of people don't even know I couldn't do that or I couldn't do this and then correlate changes. That's for them. The gate is like that higher order integration of everything you're trying to do on the table, but also like trying to pick out other stuff. So if we have somebody with Parkinson's or some motor neuron lesion, those would be the nuance. And that's tough cause that's can be nuanced upfront.

but you might start seeing things that you never would have seen because you didn't ever looked at it. think that's like, so, you know, I always think of the Robert Lardner quote of like, you know, what you don't look for, you won't see type deal. Like if you don't do the, part of exam, like, well yeah, you don't get that data. Now you might not know what to do with that data for a really long time, but then you start seeing it and pretty soon you're like, God, when somebody has a heel whip on their, you know, right side, there's a couple big options that I got to make sure that I'm looking for, right? Hip and toe rotation, big toe stiffness, ankle stiffness.

Healy version, you're like, then you go in, you're like, then you could say, look, it moves way better. And they walk different. I think to me, now I feel way more confident. Like it's good versus they get up and walk to him like, this break be tough. That's what I'm thinking in my head, right? A runner, like, they walk the exact same running. It's probably gonna be a nightmare. That's what I'm saying in my head versus like, God, that changed. Then I'm like, I could be right or wrong, but in my mind, I'm like, okay, that's a better impact. So that's how I'd wanna leave this is like.

Beau Beard (01:01:53.432)

put stuff into practice or see somebody put it into practice before you're like, yeah, yeah, know, soft tissue. Exactly. Like God, I've seen big changes or I've seen it be effective or better experience for the person, whatever that is. I think that's a really good point all the way around. So thanks for being here. Both on the podcast and the internship. it's been a pleasure. It really has. And I'm sure we'll keep in touch with Troy and hear a lot out of him and see him at all the nerdy seminars that we all go to. And outside of that, anything else?

Yeah, we'll enjoy the dinner tonight. yeah. Sound good? Sounds great. Appreciate y'all. Yup. See y'all next time.