Interview with Chris Johnson, PT: Part 1 - November 2015

The following is not original material. This interview is reproduced with permission from Cinema, a former Twitter personality & blogger who left the social media world years ago. The reproduction is intended to preserve & share Cinema's insightful interviews.

If you haven’t heard of Chris Johnson (@ChrisJohnsonPT), then you’re missing out. First, check out Zeren PT, then head straight to his extensive library of Youtube videos. Chris was also interviewed by Karen Litzy on her Podcast on Working with Endurance Athletes.

The interview provides a glimpse into how Chris has accomplished what he has so far, and what we can glean from his experiences. It’s so jam-packed with practical info that I decided to break it into 2 Parts.

Here’s Part 1. Enjoy!

So, how do you start your day? (breakfast, routines, etc…)

In all honesty, it depends on how much I had to drink the night before. By no means am I a boozehound but I do like drinking beer and happen to be in one of the best places in the world for doing so. I’m definitely not a typical endurance athlete, who is a slave to their training schedule and wakes up at 5am to train. Rather, I prefer to have a cup of coffee and read some research or catch up on world events. I also find myself doing a significant portion of my writing in the morning. One of the biggest mistakes I used to make in the past was top check my email or get on social media first thing in the morning. This undoubtedly stifled my creativity, as I’m definitely more lucid during the morning hours and need to take full advantage of this time.

Tell us about your orthopedic/sports graduate fellowship. Why did you decide to do it? And, given the benefit of hindsight, how has it impacted who you are today?

I had the distinct privilege of working in Dr. Lynn Snyder-Mackler’s lab in the UD PT department as an undergraduate, which morphed into a sports/orthopedic graduate assistantship at First State Orthopedics under Dr. Michael J. Axe. All in all, I ended up spending two years completing a Peter White Fellowship under Lynn as an undergraduate, which allowed to be a co-author on a couple manuscripts while spending nearly three years with Dr. Axe. Dr. Axe had an incredible work ethic so I was able assist him in seeing patients. He really taught me everything about clinic care and daily operations of running an orthopedic practice from the bottom up. These two individuals undoubtedly shaped my work as a clinician and demanded me to stay on top of the literature. I became very well versed in clinical reasoning pertaining to lower extremity injuries, post-surgical care especially involving the shoulder and knee, and develop a refined understanding of exercise prescription and weight lifting modifications for the injured athlete.

You spent 8 years in NYC at the Nicholas Institute of Sports Medicine and Athletic Trauma as a PT and researcher. How did this shape you as a clinician? Also, how did those 8 years shape you as a future business owner?

Having the opportunity to work at NISMAT was incredible for a number of reasons. First off, NISMAT was the first hospital based sports medicine facility in the country so it has a rich history. I also had the privilege to spend time with Dr. Nicholas Sr. (“Big Nich” as we used to call him). He was considered to be one of the original founding fathers of sports medicine and was a wealth of information. He had such a presence. I vividly remember him storming around Lenox Hill Hospital sporting his ring from the time when the Jets won the Super Bowl in which Broadway Joe Namath guaranteed the victory. He used to always remind me that “the research did not start when I was born,” and “everything in medical research comes with a date.”

Additionally, I also had the chance to interact and shadow several world-class surgeons starting with his son Dr. Stephen Nicholas, who was a pioneer in shoulder arthroscopy. I also developed a close professional relationship with the other surgeons in his practice. One particular surgeon, who I learned a great deal from was his partner, Dr. David Matusz, who is an exceptional spinal surgeon. Spending time amongst such high caliber and brilliant docs, demanded nothing shy of excellence from a rehab and communication standpoint. I was essentially their eyes and ears and always maintained close communication with them regarding all of their patients. I used to always joke with them by saying, “My goal is to disrupt your operating schedule, and cost you money,” to which they replied, “Be my guest!”

One of the most unsung heroes of NISMAT, who I’d also like to highlight, is Dr. Malachy McHugh, who is the current Director of Research. Considering the relatively small number of clinicians and researchers, it’s quite remarkable how much research the Institute publishes. Mal McHugh is one of the primary reasons for the prolific nature of this group when it comes to pumping out research. If you search MP McHugh on Pubmed, Mal’s contribution to the medical profession will be obvious and jaw dropping. One of the therapists, who also shaped me, was Tim Tyler, who is the current President of the Sports Section of the APTA. Tim had a wealth of experience and was not afraid to challenge me on every possible front irrespective of whether or not he agreed with my statements. As much as Tim used to piss me off, I realize in hindsight that it was ultimately for my benefit.

Any group would benefit modeling their professional endeavors after NISMAT, especially with their core curriculum. The core curriculum took place every Tues over lunch and involved a presentation by one of the staff members followed by a journal club pertaining to the topic just discussed.  The usual cronies sitting around the table were Dr. McHugh, the attending physicians connected with NISMAT, Karl Orishimo (biomechanist), Ian Kremenic (electrical engineer), Beth Glace (nutritionist), Tim Tyler (PT), Michael Mullaney (PT), Carmen Cheng (Managing Therapist) as well as the Sports Fellows and residents. Needless to say, we got into some pretty amazing and sometimes heated discussions and were always at the forefront of the research.

My time at NISMAT also shaped me as a future business owner though not in the way that one might think. Considering the high profile nature of several of the patients seeking our services, it forced to me to become very clear and calculated in my communication while mastering the art of motivational interviewing to elicit behavior change. It also forced me to appreciate my self worth because many of these individuals would seek me out for their rehab, which was flattering. It was always amazing to get calls from people all over the world, who would always make it a point to connect with me in the event that they found themselves in NYC doing business. I see far too many physical therapists undervalue their professional services and nothing upsets me more with regards to our profession.

What were some of the biggest hurdles you had to overcome when you opened your clinic, Chris Johnson PT, in 2010? What did you do to overcome these hurdles?

There are always going to be hurdles anytime one decides to “take the plunge” and start a business. My biggest hurdle, aside from the expensive nature of NYC, was opting to go into a space that was a bit further removed from Lenox Hill Hospital as far as Manhattan goes. This proved to be a deterrent for some though the patients, who ultimately valued my care, always took the time to travel downtown and crosstown to see me. You have to understand that in NYC, if one has to travel outside of a five block radius then it’s out of the way (first world problems ). Although business was initially slower than I would’ve liked, I took this time to develop my online presence.

After reading Gary Vaynerchuk’s book (who is also a friend/acquaintance), Crush It, it became abundantly clear that if one does not have an online presence in this day in age, they are creating a strike against themselves. Additionally, having spent the last eight years at NISMAT, without having much on an online presence, I was finally in a position to start taking everything I learned (right or wrong) and put it out there for the online community when I started my initial website/blog on Tumblr. Initially this was essentially a professional diary for me, though it soon became readily apparent that it was an amazing marketing tool and resource for people as well. Once I started getting positive feedback, I became that much more motivated to constantly write and would sit on the trains of Manhattan cranking out post after post.

Over the course of 12-16 months, I was in a physical therapist’s dream situation. I was operating a cash-based facility without doing any formal marketing while relying on no referral sources outside of patients sharing their positive experiences about working with me. I also always made sure to set aside a three hour window in the middle of the day to either train, write or shoot videos, which was an amazing way to break up my day. The only problem that I encountered, however, was that it was tough to grow a practice of this nature since no one wanted to work with anyone outside of myself. It also did not help that I named the facility after myself. In light of this information, I would therefore discourage anyone who is looking to set up and grow their facility to name it after themselves.

Staying in the universe of Physical Therapy, what important truth do very few people agree with you on?

Hands down the slow motion marching drills and isometrics (particular the ones featured in the “isometric training essentials” vid). The bottom line is that most folks simply do not have the patience to perform these drills as they are challenging, expose weaknesses, and do not make you sweat. Of the athletes I work with and coach, however, the ones who take the time to master these drills under various conditions become incredibly strong, robust athletes while improving their economy of motion. The reason I put such a huge emphasis on the marching drills is that they demand tolerance to unilateral loading while ensuring the performer can also fully weight bear through the affected extremity while assuming a balanced, upright posture. They also rely on no equipment and therefore are very practical even when folks are traveling. By slowing them down, they also demand a certain level of control and invariably demand the performer to audit the movement.

I should mention, however that once an individual masters the slow motion marching that I will increase the load through either using a weighted vest or performing them to a metronome at faster beat frequencies. As far as the upper body holds/isometrics go, they are a great way to introduce load to people. I’ve been giving isometrics for the past decade and everyone used to tell me that they were not “functional.” However, they also have a pain amelioration effect and are particularly effective in addressing tendinopathies. Cook, Naugle, and several other authors have recently highlighted the importance of training in this manner.

How did you end up with a writing gig for Ironman?

The power of social media! I simply messaged someone on twitter, who was connected with Lava, informing him of my desire to write pieces for their online publication. Within a matter of days, I had my first writing gig. Lava and Ironman eventually became two separate online publications, so I ended up sticking with the woman I had initially established communication with when she headed to Ironman full time. Writing for Ironman was very helpful for gaining even more traction online, especially with the international community, and I’m very grateful for this opportunity. I have not been writing for Ironman much as of late because my pieces are a bit technical in nature and inconsistent with their needs. This may be a bit surprising considering how technically minded and data driven most triathletes are. At day’s end I’m very grateful for having the opportunity to write for Ironman as they have built an incredible brand and still put on the best races in terms of reliability while ensuring a painfully awesome experience.

Who are your heroes? And, what is it that you admire most in them?

One of my heroes who is no longer with us was Scott Mackler (Lynn’s husband), who passed after fighting ALS for several years. He was the epitome of grit and determination. Even when he had lost nearly all of his motor abilities, he still was running a research team at University of Pennsylvania while maintaining a sense of humor. Anytime I feel like life is difficult and things aren’t going my way, I think about the challenges and hardship that he endured and I am quickly brought back to reality.

Read Part 2!

Be sure to connect with Chris on twitter: @ChrisJohnsonPT

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