Interview with Chris Johnson, PT: Part 2 - 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.

This is Part 2 of my interview with Chris Johnson – @ChrisJohnsonPT. Read Part 1 here. If you haven’t already, then head to his extensive library of Youtube videos that are well worth your time if you’re interested in specific exercise drills for rehabbing a variety of running injuries and more.

You can find Chris in person at Zeren PT in Seattle, WA.

There’s quite a bit of practical and pragmatic advice in here. Enjoy Part 2!

There’s an interesting overlap between coaching & being a Physical Therapist. Tell us about it, and how you’ve blended the two together.

First off, I’m glad that you see and appreciate the overlap. Being a physical therapist as well as a certified performance coach puts me in an incredible position to help athletes of all ages and abilities.

Considering the fact that we are human, and most likely have some remarkable past medical history or happen to possess subclinical pathology or certain risk factors for injury, it’s critical to first identify and address those risk factors so they do not come back to haunt us down the road. The bottom line is that things exist on a spectrum. All too often, I have athletes who are looking for coaching that really are candidates for physical therapy. Being able to effectively triage an athlete is critical to foster outcomes and reaching performance objectives. As I always like to tell folks, “you rehab to train, you train to compete, and you compete to redefine your limits.” It’s also funny that I’ve somehow gotten pigeon holed into being known as a running injury expert.

Considering that triathlon is a head to toe sport in every facet of the phrase I must have a solid command of the lower extremity but also of the spine, shoulder girdle as well as various bodily systems and how they interact. While I feel like I do a good job of staying current with the medical literature, I work tirelessly reading the performance literature to put myself in the ultimate position to ensure my athletes are ready come race day, or as I like to call it “harvest day.” In addition to being in a good position to help those seeking my services, I have also greatly benefitted from being a PT and coach when it comes to my own training and racing. When people ask me why I race, I often respond, “To find out how good my understanding and application of the medical and performance literature truly is.”

What are some of the most prevalent myths surrounding Performance Training?

In terms of triathlon, the greatest myth is that athletes are at a lower risk of injury considering the multi-disciplinary nature of the sport. The unfortunate reality, however, is that triathlon is a “triple threat” for injury, as Bruce Wilk likes to say. Triathlon involves three separate disciplines each with unique performance demands and risk factors for injury. Throw them all in the same pot and you invariably get a lot of over-trained, injured athletes who fall into the deep, dark abyss of a medical system that lacks the understanding to properly helm them. The other common myth as it relates to multisport endurance athletes is that weight training will only bulk one up and impair performance. The research shows that nothing could be further from the truth. Strength training has been shown to almost halve overuse injuries while improving economy of motion and rate of force development. Needless to say, if there is one thing that an athlete should do beyond their usual training for their discipline(s), it’s strength train. People would be surprised if they spent a week with me to learn how much I lift and perform drills. The irony of the situation is that most of the athletes that I work with always think I have a contrarian view until they realize that most everything I apply to their programming is based on the available body of medical and performance literature. The last myth, which continues to amaze me, is how much water endurance athletes think that they need to consume. I always laugh when people ask me how much water I drink when I compete in Ironman races. The answer is always zero, aside from occasional rinsing to clear any residual sugar from the gels and sports drink. Water does nothing beyond slosh around in your stomach while racing. It particularly leads to problems on the run secondary to all the jostling. Lastly, one of the myths among endurance athletes is that one can maintain race ready fitness year round. One of my greatest pieces of advice is to briefly lose fitness for a month. Once people get on the wheel, however, they can’t bring themselves to step off. As I always remind folks, if you don’t take planned time off and rest days, you will end up taking forced time off and rest.

This might be my favorite of your blog posts! Let’s dive into a parallel story: your knee that beat conventional thinking & carried you through the Ironman. Tell me about the journey you took to overcome your knee issues. What have you learned? How have these lessons affected you as a clinician and as a competitor?

This response could easily turn into a novel so I’ll spare you and give you the condensed version. At the age of 16, I remember the first time that I sought orthopedic consultation for a knee injury, which was aggravated by stair descent as well as when I was lining up to hit a backhand while playing tennis.

Naturally, my mother dragged me to local orthopedist for further examination. The physician’s office was a cold, sterile, and unwelcoming environment. After waiting for what seemed like an eternity, I finally was called back to see him. After talking to me for no more than a minute, and taking my knee through an orthopedic examination, he sent me for xrays down the hall. Once they were ready, he placed them on the stereogram and proceeded to point out an osteochondral lesion involving the right femoral condyle. He then muttered that I would most likely have to give up tennis and would never be able to run the rest of my life, “unless a miracle had occurred.” I did not place much faith in his words as I thought to myself, this guy talked to me for what felt like a second and failed to offer any meaningful solution to my problem. Fortunately, I sought a second opinion from Dr. Freddie Fu, a world-renowned orthopedist at University of Pittsburgh. Upon walking into his office I knew I was at the right place as his waiting room was filled with autographed pictures of world-class athletes. When he came in to see me, he also exuded professionalism, which was not hurt by the fact that he had a team of literally 10 residents and fellows following him around. He ended up having me go non-weight bearing for eight weeks before scoping my knee. Following surgery, he prescribed PT and recommended that I connect with Steve Hoffman, a well respected PT in the greater Pittsburgh area, who helped me return to playing tennis at an even higher level than before. Fast forward to my senior year of college when I was playing tennis in Florida as part of a Spring break trip which our team took every year. I was in the middle of a tight match and running full speed when I abruptly stopped and felt a sharp sensation in the anterior aspect of my left knee this time. Although I somehow managed to finish the match, I went to step into the team van afterwards and felt a strong, stabbing sensation and saw stars.

After returning to campus after the trip, I sought orthopedic consultation by the top knee surgeon in Delaware, who initially injected my knee, and had me undergo a bone scan as well as an MRI. Upon reviewing the results, I was told that the bone scan “lit up like a Christmas tree” and that I “had the knees of an 80y/o.” He diagnosed as having an avulsion fracture of the inferior pole of my patella. I also managed to get a copy of the MRI to read, which stated that I had no medial meniscus, severe degeneration of the lateral meniscus, severe chondromalacia of the patella, and bone erosions. I can’t think of anything more threatening! Although it took nearly a year before I could finally ride a bike without pushback, I finally took up road cycling. I used to always mountain bike before that, but shifted when I stopped to consider the smooth cyclical nature of the activity and how it would engender a great environment to restore the health of my knee. After a few years and several thousand miles under my belt, my knee started to feel really good again. I was no longer having any issues with walking around the streets of NYC, where I was living at this point in time, and was also tolerant of climbing stairs. Naturally, this prompted me to make an attempt to return to running.

Over the next several years, I slowly build my capacity and tissue tolerance to the point where I was running consistently while developing even great confidence in my knee. It was in 2007 when I competed in my first triathlon. Since taking up the sport, I have been injury free while racing for the past eight years and have been to Kona twice without having any signs of slowing down. I always make it a point to share this story with my patients to remind them of a few key things: 1) the body has a remarkable affinity to rebound from injury, 2) be careful of getting too attached to diagnostics as anytime you go into a tube there is nothing good that you will find out and 3) always remain patient and pro-active while ensuring that you have an accurate understanding of your situation.   

Pick one of the following you’d want as a Mentor? And why did you choose him/her?

  1. Jason Bourne
  2. Wonder Woman
  3. James Bond
  4. Tony Stark
  5. ____________ (not listed)

Bourne was the ultimate combination of intelligence, strength, skill, and getting himself out of seemingly impossible situations.

You have an incredible collection of Youtube videos! How do you come up with so many clever drills??

I first got into video recording when I used to spend my days skateboarding, snowboarding, pitching, and playing tennis among several other activities. I was always blown away by how much information one could pick up from going back to watch the tape. It’s pretty funny that I’ve continued to capture video through my professional career. While still in NYC, I initially started recording video of exercises and drills that I routinely prescribed to patients to ensure that I was providing a solid model of performance. I would record an exercise then go back to the camera to watch and would always find some aspects that needed to be changed or refined. Not only did these vids improve my own movement skills but they also started to comprise a video library for patients that I was working with in the clinic as well as a resource for folks across the globe. While we are on this topic, I think that is one of the greatest opportunities for improvement among clinicians and graduate programs. Therapists, similar to kids, need playtime and exploration to really enhance their skills when it comes to exercise prescription and demonstration.

One of my rules of thumb is that if I can’t demonstrate an exercise that I’m prescribing, then I need to either find a video that highlights keys to success or refer that person out to someone who is in a better position to help them reach their goals.

Let’s stick with the videos for a bit. Tell me what I need to do so that I too can produce sharp videos like yours.

First off, no need to spend a lot of money on fancy gear. At this point in time, all you need is a smart phone to be honest. Otherwise, everything is pretty much free. I suggest creating a Youtube or Vimeo account, get acquainted with Imovie, and start setting aside one day a week to shoot a bunch of videos. Of greater importance is to keep the videos, short, sweet and relevant. Also try to minimize clutter in the background to avoid distracting the viewer. No need to make the videos flawless either. It also never hurts to give people context. A prime example of this is when the police sirens would start up in NYC around 4pm (most likely when happy hour at the bars got underway). I used to always try to reshoot the videos, but I started to just keep the siren background as it gave viewers context considering that NYC is known to be a noisy, chaotic city. Lastly, if you plan to put the videos online, make sure to stay consistent with posting content otherwise your viewership will fall off a cliff.  

Favorite books and/or authors? Any recommendations?

Shel Silverstein: Where the Sidewalk Ends.

Otherwise David Sedaris is perhaps my favorite author. I remember reading his books while traveling on the subways of NYC and cracking up. I also like Jon Krakauer’s books in addition to any of Mark Twain’s stories. These days, however, I find myself reading “What to Expect When You Are Expecting” considering that my wife and I are expecting a baby girl in Jan 2016.

[Congratulations on your upcoming baby! She’s a very lucky girl!]

You’ve just traveled back in time and are sitting face-to-face with your 25 year old self. What advice would you give yourself?

  1. Remember that health and friends are the ultimate currency.
  2. Take money, sex, and power out of your decisions and you will never make a bad one.
  3. Read one research article per week.
  4. Never start your day checking email or social media.
  5. Make sure to read something funny before you go to sleep every night.
  6. Have transparency with others even if it upsets them as it will ultimately foster trust.
  7. Never buy more than one car per household and avoid it at all costs if you can.
  8. Make sure to learn another language.
  9. Spend a lot of time around professionals in other disciplines as it will only give you more refined understanding of your own.
  10. When you sit down to eat, make sure to do nothing else.
  11. Cardiovascular exercise and strength training are very important and one should never be done entirely to the exclusion of the other.
  12. NOW HERE or nowhere. I recently learned this from a friend, who used it when he was the MC of a wedding. I can’t think of any greater piece of advice considering the distracting world we live in. When you spend time with friends, family, and colleagues, make sure that you are present with them. You never know what you might be missing.

Chris, thank you for taking the time to do this fun & detailed interview! I learned tons, and I’m sure my readers have gleaned some great info. Thanks again!

Connect with Chris on twitter: @ChrisJohnsonPT

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