Systematizing Patient Care For Consistent Results, The Total Motion Release Story With Tom Dalonzo-Baker, PT

In a clinic with multiple PT providers it can be difficult to get consistent patient results across the team. Tom Dalonzo-Baker recognized that in his team and decided to systematize their patient care process in order to get consistent care, plus it led to better patient compliance and results! In this episode Tom shares with us the thought process that has led him to create the system and thus how he developed Total Motion Release. Giving us the steps and law that make up this system and providing us tips on better understanding our body!

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I have got a returning guest, Tom Dalonzo-Baker . Thanks for joining me again.

Thanks, Nathan. I appreciate it. I always love talking with you.

You have been on a couple of times in the past, and I highly recommend people go back and read those episodes because you share your story, and you had some great insight into your processes and procedures as a PT owner and the systems you put in place. I share it on a regular basis, “Do you know the guy, Tom Dalonzo-Baker? He shared with me a story about how his front desk person was amazing. She wanted to work from home. She was able to not only get them scheduled for their initial evaluation but schedule their full plan of care before they even walked into the clinic from her home.” That is an amazing story. I tell that all the time.

She had an 85% success rate of going through, and people thought it was impossible to do, and I said, “No, she is getting bothered and talked to you so much at the front desk in the clinic.” It was crazy.

That is the stuff that makes me value bringing you on and sharing your experience and wisdom to the readers because you found ways to systematize processes and get a continuity of care across multiple therapists. You being a math teacher in the past, developed formulas and methods for your physical therapy practice that allowed for consistent results and a greater percentage of success for your patients. I want to talk about that and tap into your knowledge base and experience. Talk to me a little bit about what inspired you to start developing these methods and how you went through that process. Maybe people can learn from your experience.

I guess my mind works out. I’m always trying to make things out. I used to say easier, but I think smoother, and I’m trying to be inclusive on things. In this episode, I would like to hammer into sometimes owners don’t realize. Maybe they do. Maybe it is me. A lot of times, I used to take my therapist, we go out, and they’d take techniques, but it never fully got us all together on the same page. It didn’t create the culture or the theme that I wanted.

When I was a math teacher, it was interesting because at 23 years old, they threw all the difficult “Kids in my class,” and they weren’t smart. They get 65 and stuff. I think they taught me more than I taught them. What happened was I realized the result didn’t matter. That sounds crazy in what we do, and everybody is trying to get pain relief. I said, “The pain relief will come. The result will come if we have the right steps going on.”

I remember this kid, Danny, would come in, and I will put 6 or 7 kids up at the board. I would give them this problem that they had to work through lots of steps. When I put 6 or 7 kids up, somebody might have 6, 8, 10, and 14 steps. I would go to the person who had six. I would say, “What was it you didn’t do that the fourteen stepper did? What was it you didn’t understand?” They look and they say, “That one I did in my head, and that one I didn’t even know about it. I forgot about that.” They still might have gotten the right answer or something.

They were more likely to begin making mistakes or not getting as much success. I witnessed it too. My kids had the a-ha moments probably at the same time that I did. It was unique because I was like going, “Oh my gosh.” What we found out is that if we kept looking and breaking the steps down, the only thing that we ever made mistakes on were add, subtract, multiply, and divide.

Does that make it so that we are stupid, or we are stupid if we do that? No, we made a mistake. It is a small fix. If there is a ten-step problem, I’m not taking ten points off. I can go up there and take one. When I came over, and I was struggling to lead my staff, I realized we didn’t have a cohesive, and I have been to a lot of courses. I hadn’t seen something that enveloped all techniques

In any clinic, if you have multiple providers, you have multiple perspectives. Multiple techniques, we have all gone to different ConEd courses. You are getting different care from different patients.

People still think TMR is a technique, and it is not. It is a concept.
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What if they have to skip between one therapist and another therapist? What does the customer experience look like? I get uneasy when I see what might be happening. I like being determined. I can see both sides of the chessboard, what it looks like from my end, and what ends up from the patients. I was like, “This isn’t smooth.”

Remember I said, “I like things easy.” I have realized I like things smooth. I said to my therapist, and I told him the story of the students. He goes, “I don’t think you will find that. I will try my best.” I will write things down and observe him, “Why did you do that? What do you next?” We began breaking things down.

You would take a shoulder patient and say, “What did you do that? What were the results? What works best for you, and what doesn’t?”

I was looking for the arbitraries that were said to be there and true, and what you had to be doing like this is the truth. I was looking for the things that we said were the truth that could be analyzed to see whether they were or not. It seemed like that was what I was doing. As I stepped through a bunch or more, and I said, “Why do I do that?” I did it. Everybody was going back to the steps.

What I eventually got to is it became these five Laws of Motion. When I did, and I added a couple more things, I was able to create seven steps that we follow, and it makes it sound like it is the seven steps are a TMR thing. People still think TMR is a technique, and it is not. It is a concept. What concept is it? It is the scientific method laid out for rehab in the full concept that it should be, even if there is research out there that is not understood. I will go through it in a second, and you can go to number one. Do I do that or do I do this?

Every one of them is hot or cold. Is it a yes or no? It is all binary, which makes it simple. You can look at it yourself and analyze your own self. How good are you at doing it that way? Have you experienced doing it that way? Where are you completely bottlenecked? Where are you completely blinded? If there are four corners in the room, and this is going to make sense in a bit, and you realize all you have been doing your entire career is looking at that corner but thinking it is the whole thing you are going to go, “There is no way.”

When you open it up, what happens is every technique falls under it. Every technique falls under the scientific method. Whether they are fully doing the scientific method relates to how good that technique is being done. I will take every technique that is out there and I can TMR it or enhance it with a scientific method. In some ways, I tell people, “If you are more comfortable, call it the scientific method fully unraveled,” rather than having it and say, “I’m doing TMR because that is another looking technique.”

What were the seven steps?

We are going to go with the five concepts first. We are going to call them the five Laws of Motion. What these do is strip away the complexity that has been added, you had to learn and put into, and they try to remember it in a textbook. If experimentation is supposed to occur, especially clinical experimentation, you need to know how to experiment.

Before I could do that, I had to figure out how are all these techniques related. Why can McKenzie go and do a press-up to get rid of a sciatic or goes from the back and the butt down to the back of the leg when you can go to a course the next week? This happened with me, and I’m at a counter strain. They take the sciatic, a patient having the exact same presentation. They flex them, and they get better.

Notice their body positions. They’re prone, supine or belly back. What if I do sideline? What if I do this? What if I do kneeling on all fours, belly back, and sideline. I said, “This is crazy.” As to this day, to think that I got to this point is mind-blowing, looking back at it. Somehow it came up. Luckily for all my students that kept asking questions, I kept thinking about it.

Law number one is this. What is the body made of that we can use as this is the machinery? How is the machine built? That is tissue. The body is made of tissue, harder tissue or softer tissue. That is everything. You got bone. That is the hard tissue we have in our bodies. We have got visceral organs. It is softer. The muscles are softer. Tendons and ligaments are harder, but that is all we have.

All these five laws should be able you to shake your head and go, “That is true.” It should, “Laws are things that you can go like Laws of Gravity.” You can drop the pen and say, “That is true.” I’m going to give you two things that you can do with tissue. I’m going to give you two things that these five things do.

Tissue can do what? You can lengthen or shorten tissue. Is there anything else you can do with tissue? You can compress or decompress. Even when you twist it, one part is lengthening in other parts are shortening. I’m not talking about blood. You could say call that liquid tissue. I’m not talking about the electricity that runs through the body, maybe the hormones, but the structural components that the hoses or the vessels are made out of everything else.

Once I got to that, I said, “Can I build off of that?” It became the second Law of Motion. The first one is tissue. It can lengthen, shorten, compress, and decompress. You can find out if it is going into yummy or it is going into yucky. It feels yummy, or it feels yucky when you move. The second one is now this, who is moving you? Is someone else moving you? Are you moving by yourself? It is clinician-directed or patient-directed.

What that means is clinician-directed is manual therapy. Patient-directed is a motion that is self-generated. We call it exercise. A lot of times, people call it a corrected exercise, but oftentimes it is still the therapist going, “You do this.” Can we make it so they understand how to do their own most? That is step number three.

You can say, “Am I a manual therapist? Am I a corrective exercise therapist? I do a little bit of both?” We are inclusive again. I’m not excluding anything. Number three becomes who is making the decision. Is it the patient or not the patient? Which means is it you or is it the patient? The decision of what motion to do. It doesn’t mean that they are going to come right in and know how to do that. I’m trying to create that experimentation so they can truly have the scientific method in front of them. I systematically take them through how to progress doing the scientific method. Number three is who is deciding.

Number four is, what area are you moving? Is it the injured area or not the injured area? Are you doing the injured area or not the injured area, which is the comfortable area? Look at own self. If I say to you, “One patient comes in to see 100 clinicians with right knee pain. Out of the 100 clinicians, what percent are going to start working by doing somewhere on their right leg, pelvis, lumbar leg, knee?” This is a 100, 90, 80, and 70. Hold up your hand. What percent of 100 is going to start on that right?

Is it all of them?

I have seminars and webinars all the time. I make them do that. I hold up their hands, and I go, “This isn’t my answer. This is your all answer.” They all say the exact same thing. A hundred percent of them typically, maybe 90%. I said, “How many of them go to the left leg to fix that right? How many of them think about going to the left arm to fix that? How many of the right arm?” “None.” I said, “Okay.”

Our professional lines say that we must be on our bad side in order to change the bad side. We have to be on our bad side. This is a paradigm that we are stuck in. It is a corner of the wall that we are looking a when there are four corners, which I’m going to show you in a second, and we have been paying attention to that corner the whole time.

One more question when you learned how to do a joint mode, and you found that the anterior-posterior was the most restrictive. Out of 100 clinicians, how many would start into treatment doing the thing that is the most restricted? The professional thing is that we were taught that. The question becomes this. Why weren’t we taught to do that most restricted one and see what the result is?

Our professional lines say that we must be on our bad side in order to change the bad side. This is a paradigm that we are stuck in.
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We talked up on number one law. You lengthen or shorten the tissue, or you go into what is yummy or yucky. You got yummy yucky. When we were joint moving, we also felt what felt the best. Why didn’t we go there and that test it with that? We have got the two extremes. What feels the worst? What feels the best? We never did that. When you start doing that, you double the amount you can do on that shoulder the opportunities you have. All you have ever looked at was doing the right leg.

Law number five is what direction are you moving in? Number four was what area are you doing it, injured or the not injured? Number five is what direction of motion are you going into, restriction or ease? That takes away all these planar motions. It takes away that we have to think about all this planar motion. Find what moves well and find what doesn’t move well.

When you go in and you realize, “I’m only staying on the right side.” My next question would be, and this may be less, how many of you now find a direction of motion like dead joint mo that you can’t do, and that is what you go into. It is a large percent. I said, “If I have you now go into what is the easiest direction of motion, you now have a new system.”

Those are the five laws, tissue, lengthen or shorten, who is moving it, they or you, who is deciding what area, injured or non-injured, and are you going into restriction or ease? Every therapist can look at that and say, “I suck at going in easy directions.” I don’t know anything about going into non-injured parts of the body to fix injured parts.

We all look at that and say, “I want to be better at that.” The same system works in it. I don’t know what to call these next 2 or 3 things, but I can show how non-injured fixes injured if you will do 1 or 2 things, and that is this. Will you test one thing in the upper body, one thing in the trunk and the spine and neck, and one thing in the legs every single session, and put down what is yucky? Score it.

For example, we do about 2 in the arms, 1 in the trunk and neck, and 2 or 3 in the legs. We get a full-body picture of what is going on in the body every single session. There is a reason we do that because when you do that now, here is what happens. When I now say, “When you go to treatment, you have an option. Are you going to move them, or are they going to move them, cells?”

They are going to move themselves. We are gonna do exercise. You are going to do injured or not injured. Let’s say we are going to do non-injured because we don’t know whether that works, ease or restriction. We are going to go into ease. Watch what happens, I go, and I test the body, maybe an on race forward, maybe out to the side, a twist, a leg raise, and a sit to stem. Left versus right. I’m always comparing left versus right.

What happens is I test the things, and I write them down. You could use a scale of 1 to 10. We use 1 to 100, but I find three motions are 50 in a 70 and a 90. Is that fair? I note that an arm motion that I found was a 50. They have got a trunk side bend that is a 70. Their sit-to-stand sucks on their left side. It is a 90. Go and do two sets of something with how many reps you are going to do, 2 to 3 sets of something. I don’t even care whether it is on the good or bad stuff because I’m going to want you to explore both. When you get done, all I want you to do is retest what you had found before. I want you to retest the yucky stuff you found before.

Is it in all of the body parts or just the bad stuff?

I want you to take the bad ones you found and retest them after you did the motion. What you will learn is, “Here I am in the trunk, and it is changing my arms and legs too. I never knew that.” There I am, and I have done one thing to the body. I don’t care what it was or how you did it. Now I say to you, “If you chose to go into restriction and you chose to stay on the injured side, I would like you to take the injured side and go into what is easy. I would like you to recheck those things you found yucky in the body, and everybody will learn that everything in the body changes everything in the body.” It doesn’t mean it fixes it. Most of the time, yummy emotions will fix things faster. Areas of injury into restriction are typically the slowest. There are only two types of tissues that work. Have I lost you? Have I caught a picture of you?

I’m trying to get a picture of what that looks like in a given session.

What it looks like in a given session is I might do an arm raise, arm-twist, and a leg raise. I might say, “You are here because you have pain walking up steps. Walk up on the right. Walk up to the left.” You were like, “My right hurts. My left doesn’t.” Your arm motion forward arm sucks on the right. When I twist, it hurts to the left, and when I do a leg raise, it is fine. I have got an arm raise that is yucky. I’ve got a twist that is yucky on one side, and I have got a going up steps that are yucky.

Nathan, you should treat in a certain way. Maybe you are going to go and treat that knee. I would like you to go treat that knee whichever way you can. You go and do it. Let’s say you’re doing it as a therapist, or you tell them, “I want you to do it instead. I know an eight-inch step hurts you. Let’s do a bunch of reps on a two-inch step or a four-inch step.”

You do it, which means you are going into restriction. You do it now, and I ask you to retest the arm raise, it was a problem, a twist was a problem, a bent knee, or going up steps, and you find out you made everything worse, or you found out one of them got better, the two of them got worse. Maybe you found out they all got better.

Now I say, “Why don’t you go over and do something on the good side of the leg? Why don’t you take a step up on the left side and see what happens to the right, see what happens in the arm and see what happens in the twist? When they do that, that blows people’s minds because now you are using the full body.

You will begin seeing that legs fix arms, arms fix legs, legs fix neck, fix jaws, twist fix a whole bunch of things, and all of a sudden, you have a way because we have a process that we put on a form, various spreadsheet methodical systematic form that lays it right up. It tracks everything. I can be an OT working on a leg, working an arm, and proving that an arm is fixing the leg, even though you are not allowed to work an arm to fix the leg.

The only reason you are not is because your form sucks so much. It is not that or my doc gave me a script that said work the leg, do the knee, and you’re up in there in the arms. What are you going up in the arms? I’m showing every two sets what I’m doing and what it is doing to it because everything is connected.

If the legs are messed up and being pulled down like this, your shoulder won’t ever fix to the fold. What would take an aerial view of this? What we have now is a means to create seven steps that every single time we treat any condition, we can test the full body first by these fab six that we use, pick them, and buy the area in which they are injured in. They didn’t come in to do those six motions. They came in to do what was their area of injury.

We can then score it. We can then treat it. We got number one, test area minus 5 and 6, which is a single move, and then the area of injury. Score it, and we can test. There are four ways to treat it. We are not going to go into those. Number five says retest the whole body. That alone will get everybody massively on the same page in the entire profession. If everybody would do the scientific method the way like this, you would be using everything, and we would all get the same answers.

The number six simply goes, “There are three rules.” One is, what if it gets better, what do you do? What if it plateaus on your fatigue, what do you do? What happens if something gets worse, a new pain comes on, and something funky happens? That covers everything. There is one rule for that. The next one is when do I get to move to a new exercise, a new motion? That is it.

You could do it manually. You could do a corrective exercise. You have a form that you can look to see if your people are doing it, or you, as another therapist looking at another therapist form, can go. “I know exactly what they did.” The patient can look at the form and the seven steps and tell what they did. The patient knows those seven steps and says, “I’m doing it.” Everybody is almost checking each other up and down the scale. It is now an accordion.

I love how you took that and made it a system for your team. It is something that I know you put some work into yourself, but you did it with your providers, if I’m not mistaken. You sat down and said, “How are we going to get on the same page with shoulder patients, and what does that look like?” They can come into it with their own techniques, but there needs to be some similarity and consistency across the board as we are treating.

If everybody would do the scientific method the same way, we would all get the same answers.
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We have taken McKenzie and added more scientific methods to it. We have added more of these five laws to it. We have taken a mulligan. It is the same exact thing. We didn’t drop the ball. They just didn’t see some of the corners. What do I mean by corners? I’m going to make it real simple is that I’m a math guy. Maybe it is not too simple. We live in a three-dimensional universe.

What that means is there is an X, Y, and Z-axis. When there’s an XYZ axis, it looks like this. You don’t have to remember Z and X. That is one of the things that I like to do. Here is your nice smiley face, feet, and hands. You are two quadrants. You have an upper quadrant, and that includes your right shoulder, your right arm, your neck, your ribs, and your thoracic. If you are treating a right shoulder, you think that is the quadrant you stay in. Most people do it into restriction. You can also do it into ease.

Now, looking at that picture, there are two ways to do everything in each quadrant. If you have only known how to do the injured quadrant into restriction, you know how to do 1 out 8 ways. You know how to use 12.5% of the body to fix someone. You don’t know how to use NDEs. You don’t know how to use this side, this side or anything. You don’t have as many opportunities to solve somebody’s problem like I do or anybody who’s taking TMR.

If I give you the opposite side, all of a sudden, you see me working the opposite side, which when I lift this arm up, it shortens this side. When I’m doing the opposite side, I am shortening the one that I’m trying to fix. When I’m lifting something up like this, I’m lengthening it. By giving you ease and restriction over here, not only you have added three more folds of the ways you can help the patient, but now I give you the whole 8 out of 8, and you have no problem fixing somebody with left leg for the right arm. It is not even foreign or odd to you.

It is not even foreign and odd to them because of ways to also address with the patient. Simple to say to the patient, “If we use this into restriction and it gives you this improvement. We go into what feels good, and it gives this improvement. Which one do you want to do?” If we come over on this other side and as I lift this up, it shortens this side, and it works better, which one do you want to do? If I go down to the trunk and I lengthen that this side or I shorten that side and that one works better, which one do you want to do?

If I go to the leg and I kick it up, which shortens the tissue here, or I kick it back, and it lengthens the tissue, one of those does this much improvement, which one do you want to do? If I go to this side and it does this much improvement doing, which one do you want to do? All of a sudden, it breaks them up into this because culturally, if you have a right knee problem, you think somebody should treat your right knee. I have to go through that type of cycle to get their brain also opened up to the four corners or the four quadrants of the body. That’s a lot all at once.

For the owners that are readers, for them to take something away from this, if they are not necessarily going down the TMR path, total motion release path, at least be systemic about something thought process and get your providers together to consider what they could do to get on the same page and start with looking at the other side and maybe the other quadrants.

The thing is, there have been thousands of years going at it. I can’t tell you. I’m not a brain surgeon. I’m not a smart guy necessarily. I don’t know why I felt it. I’m not sure. Maybe it is because I came from the teaching profession. Maybe it is the way I tried to help my kids, and I observed some at the time. This has never been observed anywhere else.

When you begin seeing it, you are going to go, “He was right.” The majority of my people that come to TMR are several years out. That is the average person that comes to TMR. They have seen all that stuff. The best thing is to try going into ease whether you need some other things when you start doing the other side. Once you do and you catch onto it, and you have the form, you are going to be able to say, “Now I know how to bring everybody together. I will still allow them to treat manual techniques, whatever they do. I will still allow them to mulligan, but we can all be using the same form no matter who comes in.” Forget all these other special tests that people are doing or these special forms they are using. Every single condition can be done in one form.

It means everybody can see and understand what everybody is doing. When you go and say, “How many people are completing?” You are reviewing your charts. Everybody is reviewing and understanding what everybody else is doing. It adds massive consistency. I have got a policy that is now using TMR as the foundation course they teach. They build off of that.

That is what I say to owners. “As owners, at least, you guys need to take a TMR at least level one to get the idea. If you come and purchase it with your staff, I will talk about what you and I are talking about.” I will take the people who buy as a staff, and I will say, “How do you now create that culture? How do you take somebody from a 35% success rate or completing patient to 82% completion rate?” I like to work with those who do bring their whole staff involved.

You bring up a key statistic industrywide, and I know you know that our success rate of uncompleted plans of care is about 30%, which is horrific. There could be varied reasons as to why that is, but we are not connecting with the patient and getting consistent results within a clinic. Whatever we can do to start helping patients and therapists to recognize the value of the therapy they are providing will be a great step in that direction. It is a statistic that needs to be measured if it is not at this time by PT owners.

When we put this in place, it took us six weeks, from 35% complete to 82% complete. I think we got up between 87% and 88%, which is a pretty darn good completion rate typically.

My friend, Eric Miller from Econologics, says, “If you ask people, what is their biggest cost center? Inevitably, they will say salary.” He said, “Your biggest cost center is lost business that you are not capturing.” If you have 200 appointment slots available and you are not filling all 200 appointment slots, that is your biggest cost center. Your growth, expansion, and getting the patients to come in for their full plans of care, coming in at the frequency they are supposed to come in on a routine basis, is your biggest cost center. Focusing on that more than your salaries will get you further as a business.

What we saw is that we did so much work, and we were measurable and stuff too. The big stuff that kept popping up was our completions. That is when probably one of the big impetus with me is how do I get them when they are all speaking different languages. Everybody is doing a different technique and is good at this. I said, “How can I make the people who are awesome more awesome? Is there a connection between it?” I never would’ve expected it to come out to look like what it did.

A lot of times, we will focus on, and even I, as a coach for PT owners, focus on what they are saying at the front desk, which is important. I rarely talk about what they can be doing in the “back office and patient care?” We will talk about what we can do to engage the patient and get their buy-in at the initial evaluation. There needs to be that consistent visit after visit, showing some value and progress if we get their buy-in.

When we realized this part of it, it became the center core of our company because we could use the good and the bad. It is the way we are doing it, and even our front desk took the course. When they were talking to the person, they would say, “What lesson are you on? Where are you in your thing?” They could use it to then talk to the patient because they were able to look at the form and what was going on.

It is fascinating when you see a process and a methodology, but nobody is out there looking at the therapy. We make this assumption that they have got the service orientation, and they have got the quality. We know that if the VIP walked in the door, who we are going to give them to. It might be ourselves if we are still there. We can use techs in North Carolina. Most of ours were athletic trainers or kinesiologists.

I was fine letting my tech do a VIP if it needed to be. That is how good they were because of this. We had some interesting people come into the clinic, and they would only get a half-hour of the therapist in the half-hour of the tech. I had no problem because I knew that we all knew the same stuff going on. They ended up sending their daughter and their mother. It is all that we had.

It is impressive because, number one, you systematized the process. It wasn’t just Tom Dalonzo-Baker’s physical therapy. It was blankety-blank, physical therapy. Whoever you went there could get consistent care, no matter who the provider was. It is something that they developed as a team and as a culture. I like to point out that having your front desk person go through some of that is valuable.

If they can speak the same language because of me doing EMGs, I’m not answering the phones, but my front desk person is answering them. They are getting a lot of questions from potential patients about the care or the test that I’m going to do. If they can’t speak the language and are fumbling over their words, it will be hard for them to sell.

We started this with that lady that had an 85% success rate of getting people to schedule twelve visits because you should have seen her change with TMR, her whole body. She could communicate and ask them. She was into saying stuff like, “What is going on with you?” She could say, “I couldn’t twist at all when I was having something going on. Are you going to do this crazy stuff? How many people have treated your leg to fix your arm? It is all connected. Why wouldn’t they?” She is selling that part of it. That was the beauty of it.

It is fascinating when you see a process and a methodology, but nobody is out there looking at the therapy.
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Every single person knew and could talk. As owners, I don’t know how many times you feel like that thing is pushed your in your direction for the more educational part of the therapist handling things. Oftentimes, the front desk can’t do it, and they funnel it off. Most of the time, our front desk could.

Many times, the therapist might go through all of that. Maybe you have experienced this. The patient will then turn around the corner and goes, “Talk to the front desk,” and ask the same question and hope to get a different answer. They weren’t quite getting it, or maybe they wanted that in layman’s terms. If your front desk doesn’t know what is going on, they are not going to be able to be supportive in that regard.

What they say is, “I don’t want an answer. I want to hear my answer on your lips.”

I know that is what you have been preaching this entire time. It is a lot about what you do well is you generate systems. I know this, and after talking to you a few times on the episodes, you generate systems and try to make it simple when things are going wrong. It is like, “Do we need to change it or do we need to fix something that went wrong along the way?”

Simple and inclusive tip. You will hear techniques fighting between each other. I know why McKenzie stuff and William flexion work. I know why mulligan works and when it stops working and whereby a little flipping of standing on one leg, as you do the mulligan can make that mulligan work, those things happen. That is neat to see as you get out there.

If people wanted to reach out to you and learn a little bit more, how do they do that?

My website is set up as a training lesson. You go to TotalMotionRelease.com, and you will see, step one, I show it working on people. It is crazy stuff. You will see somebody with jaw and neck pain get better with a sit, to stand on the right side, or something. You will see eye pain and weird stuff. You will see a spine surgeon doing an arm press on a fitness piece of equipment to change. It is great, cool stuff.

There is an explanation of why is this working. It gives you the five laws. It steps you through and tells you, “Are you an owner? Do you want staff training, or do you want individual training?” It is all sitting right there on the page, and you can get two free CEUs by taking our two-hour web class, which you can take as an on-demand home study. Every couple of weeks, I have one live also.

Thanks for sharing. I appreciate it.

Thanks for having me on.

Is there anything else you want to share before we take off?

To have all that thrown out at once, maybe people had to read this a second time because they weren’t expecting it, or maybe you need to watch it with the videos. Most people have to see that and go, “What the hell?” You’ve got to see it. When you do, you will have more to talk to. You guys are a clinician like myself. You will find out that I’m highly accessible. If you go watch something, you go, “I got to talk to Tom. My cell phone is on there, text me, and we can get up and chat.

Thanks for your time, Tom. I appreciate it.

I appreciate it, Nathan.

I have owned and operated 4 PT clinics in North Carolina and sold my last one to my staff in January 2017. I am the founder of the Total Motion Release (TMR) Method and a seminar company called TMR Seminars. Our courses include TMR, Dry Needling and TMR Tots.

A patient once asked me, “How good are you at fixing your patients?” And I answered Top 10%. He didn’t blink an eye and then he asked, “How good are your patients at fixing themselves?”

That one question changed the entire trajectory of my career and my skillset as a PT & owner. I wanted to be good at giving my skill to my patients and my staff.

From that point on I observed, explored and learned again and again how to get others to help themselves.

The Total Motion Release Methodology began this exploration and was the first path I followed to create a mini-owner culture amongst my staff. Have a listen and I hope my journey will inspire in you the desire to do the same. Enjoy!

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