The Road to TED Talk-ing

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After watching my Duke Blue Devils conquer the ACC Women’s Swimming Championship at Georgia Tech this weekend, I spent the better part of my weekend devouring some great TED talks. Not only were the messages by Shirzad Chamine and Brene Brown inspiring and refreshing, but they also gave me the opportunity to reflect on my own recent public speaking experiences.

Two weeks ago, I had the honor and privilege to do what I consider two of the most humbling experiences of my professional life: speak with and in front of colleagues at the American Physical Therapy Association’s (APTA) Combined Sections Meeting. In keeping with the fact that it occurred the same week as the Super Bowl-we’ll  basically equate this to the Super Bowl of all PT nerd-dom, complete with fanfare, its own hashtag, an exhibit hall with plenty of games and freebies, and plenty of evening parties. Just imagine 10-15,000 of your best nerdy PT friends all descending on one giant convention center in snowy, frigid Indianapolis (seriously, whose idea was that?). It was a geek fest- but a very inspiring geek fest at that. And some may argue it offered some great people watching and fashion critiques. Apparently the token wardrobe for PTs is still believed to be khakis and polos, if you were wondering (there is an entire Twitter conversation about that).

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They even decorated the stairs with nerdy PT-isms

I found out last summer that I would be speaking, so there was plenty of time to prepare. Like the athlete that I am, I spent weeks training, rehearsing, polishing, and preparing my presentations so that I could get up there and deliver the presentations in true TED talk style. I read a book, watched tons of TED talks, and ran the talks by several colleagues and students. I selected outfits that would convey my personality. People: I wore HEELS for crying out loud. I spent hours in the convention center’s “practice room” making sure that the computer and projector were compatible and that all of my photos and videos shone through to convey my visual message. An audiovisual snafu was a worst nightmare for this overprepared, overachieving, nerdy PT.

Completely relaxed and confident, I walked into presentation 1, plugged in my computer for one final test, and it popped up beautifully onto the screen. I was speaking among 10 other experts in sports medicine. I was 7th in line to speak, covering a case study of a young female athlete swimmer (does it get anymore exciting for me!?). I sat listening to my colleagues share their stories, eagerly awaiting my turn to take the podium. It was finally my turn. I thought in my best Kevin McAlister homage “This is it, don’t get scared now,” proudly took the stage, and plugged in my computer.

Womp womp.

As Murphy’s Law would have it, all of those hours of preparation and practice came to a screeching halt. The A-V connection wasn’t working. What!? I’d practiced and tested it a minimum of 23495 times on this very projector! Why wasn’t it working? I had approximately 1 minute to get it sorted out before they told me to get off the stage and let the next speaker go. That 1 minute went pretty quickly and unsuccessfully, and off I went, sheepishly back into the audience.

Now, this could have been a total game changer. First time on a big stage and my computer malfunctions. The whole world can now seemingly assume that I wasn’t prepared. But…but..I practiced!! I swear! And I even bought the special Mac adapter! A charitable stranger offered up his PC computer and I spent 20 minutes transferring files, videos, and completely rewriting my talk. Apparently presentations written on a Mac don’t always transfer perfectly to a PC (Insert elitist Apple statement here). I finished everything just in the nick of time and retook the stage.

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Talk 1: The Long Term Effects of Slipped Capital Femoral Epiphysis (SCFE) in Young Female Swimmer, part of the Sports Section’s Complicated Patient Session

By this time, I was going last. Nearly half the room had emptied as people left early to catch lunch. It wasn’t what I had envisioned. But I charged on. To my surprise, I was even more relaxed this time around. I thought, I suppose it can’t get any worse… The projector worked, I didn’t even need to consult my notes, and I delivered the message with ease and grace—even inserting a little humor here and there. After the talk, I had some wonderful conversations with PTs and PT students who were so thankful for a talk about swimmers-a topic that is rarely covered in a sports medicine world heavily focused on more traditional sports.

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Thanks to the faithful who stuck around to see me dressed in a Missy Franklin costume!

First talk down. Snafus aside, I was pretty proud of myself. Now that I had ripped off the proverbial Band-aid, I was more than ready for the 2nd talk the next day.

For the next presentation, I was speaking with 2 of my most valued mentors and colleagues-Blair Green & Julie Wiebe. See this post and this post and this website to learn more about Blair. See this blog and website featured in my Blogroll to learn more about Julie W. Needless to say-they are both rock star PTs that I really admire, so it was a honor to stand up and speak with them.

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Here I am in Talk #2. Credit to Julie Wiebe for the awesome slide. Credit to Jen Miller for the photo.

I was up first. I joked that they were hazing me and made me go first and explain all the “sciency” concepts because I was the baby of the group. For the record-It is NOT easy to speak continuously for an hour! Talk #1 was only 9 minutes. This one took me 65 (apologies to Julie W for being long-winded…I blame the bad video connection!) The good part about having to teach a big group science concepts is I also got to exercise my inner 3rd grade teacher-meets-kids Pilates instructor. Getting a room of 100+ people on their feet and making them wiggle and do some silly things really does give an air of feeling powerful (or maybe that’s just what I’m telling myself).

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Audience on their feet, following directions. What fun!

We had a pretty awesome message to share, if I do say so myself. The presentation, Building the Female Athlete from the Inside Out, conveyed the most current ways to build and fashion a female athlete’s movement performance after injury or impairment. We took a multifaceted approach, covering three unique cases. I discussed a young female athlete (my wheelhouse!), Blair shared about a post-partum runner (her true love), and Julie W anchored the relay by taking on the beast of the CrossFit/High Impact athlete (seriously, she is the only person I know who can talk publicly about that hot topic and not get tomatoes thrown at her).

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Here I am with the Female Athlete Dream Team: Blair Green & Julie Wiebe. Fully representing The Georgia Bulldogs and Duke Blue Devils in our color scheme.

Of course, this presentation was not without its blessing from Sir Murphy and his law. While I had carefully ensured no encore performance of the computer issues I had in talk #1 (of course I had!), it turns out there were more issues to be had. This happened in the form of the presentation completely shutting down in the middle of Blair’s portion. <Cue potential panic attack>. Good news—turns out we could give the presentation in our sleep and she carried on and handled it like a champ while I scrambled to help her fix the problem.

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#nerdclub president takes the podium. Who cares if the presentation shuts down in the middle? No biggie.

Overall in that talk, we had our share of issues and imperfections. There was certainly a laundry list of things to improve upon in the future. Despite those things, the outpouring of support and gratitude following our presentation was humbling. We were tweeted, retweeted, facebooked, Pinned, emailed…the list goes on. As far as social media goes, we were definitely feeling the PT nerd love.

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I’ve sat in many talks tweeting stuff the presenter says. Now I’m the one being tweeted. #whoa #humility #carefulwhatyousay

But perhaps the most rewarding feedback we received was at the conclusion of the presentation. As the last presentation on the last day, we were afraid nobody would stick around for our talk. On the contrary, we had a room full of engaged attendees. As we entertained questions from the audience, one attendee stood up from the front row and said nothing, but just began clapping. She turned to the audience and continued to clap, offering up her own personal standing ovation. I was thinking to myself wow, this attendee is quite enthusiastic. Not to mention she has some guts to stand and do that. She then turned to us and said “Ladies, you NAILED it.”

 

Then she identified herself. It was Mary Massery.

 

For those of you who aren’t PTs—this would be akin to having Coach K stand up and applaud you as you gave a talk to the entire NCAA on new and innovative approaches to coaching men’s college basketball. Yes, of course I’m going to use a Duke basketball reference after that win over UNC this week.

We were starstruck, to say the least. For Blair and I, both of our jaws immediately hit the floor. According to Blair, this was like being thanked at the Oscars. Julie W knew her previously but it was clear that was very meaningful to her as well. When I was in PT school, I was told by multiple professors that if you ever had the opportunity to learn from Mary Massery-you do it without hesitation.

To add vulnerability to humility—I had even quoted her twice within the presentation, not knowing she was sitting on the front row. This, ladies and gentlemen, is exactly why we are always taught to check and double check references before quoting someone! My 5th grade and high school journalism teachers would be so proud.

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Giving credit where it is due!

Mary happened to escape the room before I had a chance to thank her and shake her hand. Good news is she’s coming to Atlanta later this year and I will get to do that AND learn from her, as recommended to me when I was a novice PT. She did send an email to us later commending us on our effort. It’s not quite a hand shake, but my jaw may or may not have hit the floor again.

Overall, it was a wonderful experience. Among my many reflections, here are a few pearls I picked up along the entire journey:

  1. Like in any sport or activity-you can prepare, rehearse, perfect, and polish to the nth degree-and things will still go wrong. The key? Learning to roll with it and breathe through it. You’ve got this.
  2. Humility, vulnerability, and grace go a long way. It’s not about YOU in sharing your message. It’s about the people with whom you share it. It’s more important to establish a connection with them in order to get the message across than to worry over the details of the actual message. People only retain 10-20% of what you say. So it’s not about what you say-it’s why and how you say it. Be yourself, add some humor and fun—and people will really engage with you. This makes it a lot more fun as the presenter, too.
  3. I say this all the time—but teaching is not a teaching experience. It is a learning experience for the teacher.
  4. Blogging is a fantastic platform for sharing passions and messages. It’s even more fun when you are given an actual voice on an actual platform, and you get to wear heels to do it. Thank you Blair for letting me raid your shoe closet.
  5. The unconditional support, compassion, and reinforcement I received from people who barely knew me was so humbling and validating. It has been amazing to receive messages and emails from people who just want to network and share their stories with me. What an incredible profession to be a part of.
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Duke alums in PT gathering! Some of my favorite PTs in the world in this photo!

I’m thankful for the opportunity to have shared my stories and passions with so many people. I can only hope that even just one person has been able to integrate some of those concepts into their daily practice.  I gained new inspiration not only for this blog, but reinforced and reinvigorated my curiosity and passion for so many things related to the care of young athletes. As I come down from the CSM high-or hangover as I’ve called it-there is plenty to integrate into my practice. Lots of new connections, friends, and knowledge. I haven’t even started to reflect on all the cool things I learned at the conference in all the classes I took (another post for another day). Stay tuned!

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Emory DPT Classmates. Love these guys!

 

Swimmer’s Shoulder: Best Friends and Mortal Enemies

Athletes of all ages and backgrounds thrive on efficient movement, maximizing results with as little energy as possible. In swimming, inefficiency can lead to many injuries, especially shoulder pain. Meet a swimmer’s best friends and mortal enemies. It’s often the enemies—those that pretend they’re friends—who cause the most trouble. ­­

BEST FRIENDS

KISS Principle and the 3 Bs

When it comes to swimming efficiency, we need to establish two simple truths for keeping it simple, swimmer (KISS):

Truth 1: Swimming is not all about the arms. You may have lats (“swimmer muscles”) of steel, but they do more than propel the body in water. They interconnect with the core and are sewn into your glutes. The arm bone is connected to the leg bone after all! But that doesn’t mean it has to do all of the work. Truth 2: Swimming is all about the 3 Bs: balance, buoyancy and breathing. But how do you make those your best friends? Read on to find out how to use them to help your arms and swimming efficiency, specifically in the freestyle (front crawl) stroke.

Be strong and carry a big kick

“I am not a strong kicker” and “I hate kick sets“ are common quotes from swimmers with shoulder pain. We may love-to-hate kicking, so let’s make it more digestible with a metaphor. Imagine you have a beautiful boat that you use each week. You’re thrilled until one day—BAM! The boat starts to slow down and feel sluggish each time you take it out. You take impeccable care of your boat, so you’re baffled. You take the boat to a mechanic, who asks how you drive it. You proudly present two paddles that you hand-carved. He smiles and points at the boat’s motor. “This is a motor boat,” he says. “Have you been paddling it all along?” You answer, “Yes! I don’t want to pay for gas and put in the time to service the engine!”

Friends don’t let friends overlook the importance of having a strong motor in the water. Using your “paddles” to do all of the work is not only inefficient, but it will slow you down and worse—potentially injure you. Dragging your motor along is added weight for your arms to pull. Use that weight to your advantage! Find a precisely balanced use of that motor coupled with good body rotation (twist), balance, and buoyancy so that you won’t have sore “paddles.” Want to know more? See this article about efficient freestyle kick in swimmers and triathletes.

Do the twist

There is no one-size-fits-all answer to swim posture and balance, but here are a few guiding principles:

  • Head position: Head position and shoulder pain are related. Poor head posture begets a sluggish hip position and vice versa, leading to a sluggish motor. Gaze through the top of your goggles instead of tilting your head up. Keep the water line at mid-forehead or cap line.
  • Pelvis and hip motion and rotation: drives the kick, which in turn drives the body, then the arms. This requires glute and hamstring strength and flexible hips.
  • Upper back: follows the pelvic and motor motion. You need flexibility and strength into twisting motions in the upper/mid back, shoulder blades, abs, and low back.
  • Knees and ankles: neither held too rigid nor floppy. Kick from the hip, not the knees or ankles.

Utilize your own personal floatation devices

If you don’t breathe well, your motor and 3 Bs will suffer. Swim lessons begin with bubble blowing and floating for a reason: to teach use of the most buoyant part of the body—the lungs—to stay afloat. Diaphragmatic breathing keeps your core engaged with your arms and delivers oxygen to your muscles. And be an equal opportunity breather! Breathe bilaterally to keep the work balanced on each arm/leg.

Swim toys: the good guys

  • Swimmer’s snorkel: Ditch the nose plug. The swimmer’s snorkel may help you with the 3 Bs. It keeps your head and body in line while working on your body rotation and kick. Sure, you won’t breathe to both sides or compete with it, but it does help you sync your inhales and exhales with your strokes. That’s a step toward 3 B success and a best friend for swimming life!

    Photo credit: swimswam.com

    Photo credit: swimswam.com

  • Swim fins: Not only will they help you practice your Little Mermaid impression, but swim fins will also help you run over everyone at practice. While they are no replacement for establishing an efficient motor and 3 Bs on your own, they do boost kicking and, in exchange, take a load off of your arms. Word of caution: if your ankles are stiff, they can cause shin pain.

Hand entry

It’s easy to get caught up on hand entry (pun intended). It’s important, but not everything. Hand entry is akin to a runner’s foot strike: both are dependent on body position. This has less to do with your arms and more to do with—you guessed it—kicking and the 3 Bs. With these in check, the hand should enter fingertips first, just wider than the shoulder. Too wide or too narrow likely means there’s under- or over-rotation in the hips and torso, respectively. This can lead to technique issues and stress the shoulder.

Training terrain

This is mainly applicable for triathletes and open water swimmers, though pool swimmers can benefit from this part, too. Just as trail runners need to train off road and road cyclists need to train on the road, swimmers need to train in their competition “terrain.” Accessibility, weather and water temperature pose a challenge here. For open water races, train where you can’t see in front of you. Vision affects the 3 Bs, so practice lifting your head too look for race buoys, support crew, and other competitors. Just remember keeping your head up too long will affect your 3 Bs and motor. If a current or waves are involved, train in choppy water. Wear your wetsuit before race day to ensure fit, comfort, and no change in your 3 Bs.

MORTAL ENEMIES

Improper FITT

That’s not a spelling error, and I’m not referring to swimsuit fit. That’s training Frequency, Intensity, Type, and Time. Too much or too little of each can be problematic. Periodic muscle soreness is normal, but should taper with experience and improved technique. Increase training distance or duration by no more than 10-20 percent per week and vary your strokes to allow for this gradual change. Having stroke variety (e.g. breastroke or backstroke) in the back of your Speedo can be handy if you need to change your position or speed in a race.

Swim toys: the bad guys

  • Kick boards: Kicking is essential to healthy shoulders, but kicking with that 12-inch piece of foam is not. It puts the shoulder in the “impingement” position, pinching your rotator cuff and other structures against your scapula. That’s PT-speak for “ouch.” Kicking with no board helps master the 3 Bs. Kick on your side with one arm up or on your back or stomach with both arms down.
  • Hand Paddles: These are a privilege, not a right. Added resistance is great for building shoulder strength and to the swimmer who paddles the motorboat. Remember what I said about the arms? It’s not about them! Unless you have no pain, a good kick and the 3 Bs, just don’t even go there.
  • Pull buoys: Why would you take away your motor especially when your shoulder hurts?

Poor ergonomics in other activities

What you do out of the pool is just as important as in the pool. Poor cycling and running posture can beat up a shoulder. That goes for workplace, school, and car ergonomics, too. Habits accumulate quickly and can catch up to you when you least expect them.

IN SUMMARY:


Now that you’re armed with a checklist, you’re ready to dive in and make lots of new best friends. But if you find you’re having trouble with them, don’t wait until you’re in pain to ask for help. Sports physical therapy is not just for when you’re broken. We can identify factors that may put you at risk for injury not only in swimming, but in other activities too. Video stroke analysis can be key to help identify and correct errors that may strain a shoulder.

USA Swimming: drowning in scandal?

Say it ain’t so…

I am not typically that person who posts anything negative on social media.

Until now.

As a former youth swimmer who came up adoring all things USA Swimming–and now a professional who works on the other “role model” side of it all, my words are few. And that’s saying something if you’ve seen the length of some of my posts.

To say that this article gives me a heart-wrenching, visceral response is an understatement:

http://www.outsideonline.com/outdoor-adventure/water-activities/swimming/The-Sex-Abuse-Scandal-Plaguing-USA-Swimming.html

But it’s just a news magazine, it can’t be right…

There is more than one side to every story. That little girl in me who fell in love with the sport–yes, she still lives–she wants to wake up tomorrow and realize that this was all just one big nightmare. How does it go? Innocent until proven guilty, right? However, the adult in me who lives in 2014 amid countless other adult-youth sex scandal stories thinks otherwise. Given the reports that it is (and was) so widespread and recurrent, something tells me that no, the rational side of me is probably right. Maybe it’s just a sensationalized story from another news media source, right? No…this is actually a magazine I generally tend to respect. <Sigh>

There has to be an upside, right?

Let’s just use this as a great opportunity to give a shout out to all the top-notch, role model swim coaches out there (both male and female) who have set a positive example and have helped shape not only me, but my best friends and all of the young swimmers of today. I’m ashamed and disgusted that there are monsters among our swim family who are trying to bring down such an awesome sport we’ve all put our blood, sweat, and tears into. I can only hope that some positive will come from this and keep all the young girls out there inspired to keep their hearts and minds in the water and keep on churning out yardage to reach all of their goals.