How to Rewire Your Brain For Success in Cash-Based Physical Therapy

Hey Primal Fam!

Today we are going to talk about stress and load on a system, and SPECIFICALLY how stress and load are important for systems like your body and your business.


The Importance of Stress and Load

As physical therapists, we REALLY understand the importance of stressing and loading the body for optimal performance. We know (maybe better than any other profession), that stress and load are necessary for growth and regeneration in our bodies. We fully appreciate that a living system must regenerate CONSTANTLY, rebuilding 330 Billion cells DAILY in order the stay healthy.  When we don’t rebuild and regenerate, cells and/or the system will die.

SO, how do we demand repair and regeneration in our bodies?

By exposing it to controlled stress. If we are not constantly pushing stress onto a living system, things like the muscles, joints, and ligaments in the body will not be coerced into repairing and regenerating, and will ‘die’.

And so the lesson in our living system is this:

Stress the system.

Demand growth and change.

Or die.

This may sound harsh but it is – oh, so true. First  a few cells die…. then many. Eventually the system becomes so unhealthy that it becomes overwhelming to address all the needs.

How does this apply to business systems?

Our business IS A SYSTEM, much like our bodies.  There are many, many facets and components to a business, all which must be pushed, stressed, and attended to in order to demand growth and change.

If we want our business to thrive…

If we want our business to grow…

We need to PUSH CHANGE!

For simplicity, let’s go back to our body system example, to draw the parallel of this need. We know that in a muscle tissue if we do not load its joint 60-85%, we will NOT be able to get the desired type 2 muscle fibers, and therefore will NOT be able to attain muscle hypertrophy.

The point of bringing this up is to REALLY reinforce that our body LITERALLY has a built in system that FORCES us to invoke change in order to thrive.

Let’s talk about tendons!

People who are athletes commonly get Achilles tendinopathy. We now understand, after years of research, that JUST resting and icing tendons won’t really  move the needle in getting those patients better. We now KNOW that the only way to REALLY get these stubborn tendons better is by LOADING them! When we LOAD the system with eccentric exercises, it will get the blood flow and healing that it needs in order to demand the changes required to recover.

How about bones!??

Astronauts have to PURPOSEFULLY load their system in order for their body to stay safe to be in space. Wolff’s law says that a bone will adapt according to the load which is placed on it… and that if load is placed on a bone over a time, it will become stronger in order to resist that load. We are REQUIRED to load our bones if we want to prevent breakdown and deconditioning due to loading limitations such as those seen in astronauts in space.


Applying Stress and Load to Business Systems

Embracing Stress for Personal Growth and Professional Development


If you dont seize opportunities that come your way, you’re essentially being “fear avoidant”, which we know in physical therapy is a huge marker of outcome failure in the patient population.

Turns out this is true in business too.

When I look back on my personal/professional growth early on, I did not let fear or stress limit my willingness to face a stressful situation.  When you have an opportunity in the business system, regardless of the stress it might cause, you GOTTA take that opportunity.

When I look back on the work I did under my mentor many many years ago, I remember welcoming “stress” to my system all day to learn from him. I would treat patients all day and then work through lunch or stay at work very late listening to his ideas and thought processes or writing his presentations for him.

One presentation I wrote with (for) him was for a very large, high profile orthopedic symposium.  This was in a very large auditorium, filled with doctors and experienced physical therapists. I was on stage preparing the slides for my mentor when I got a call from him saying that he would not be able to make the presentation… I would have to give it.

I remember at first, my heart beat came through my neck. The anxiety of presenting for this large group of experts when I was such a “newbie” was very scary.  But I could not let this stop me.  If I wanted to grow, I had to allow STRESS tp the system. This was my chance. I couldn’t let it pass.

And what do you know? I gave the presentation, and not only did it go great, but I made a ton of new contacts and grew personally and professionally in the process. Was it scary at first? Absolutely. But the fruit of facing that stress produced more growth in me in one day than I could have ever achieved by exposing myself to many other “easier” scenarios.


Professional Growth Through Teaching and Learning

Quickly I noticed the pattern that when I stressed my system in the professional setting, the benefits that came out of it were endless. 

So after pushing my own limits regarding learning and understanding new material in physical therapy (skills and knowledge), I realized if I was going to grow anymore I needed to once again stress my system and require more from myself.  

This is where teaching came in.  If you REALLY want to OWN a concept or skill, teach it to others.  You learn it on a whole new level.  You learn all the intricacies and details of the technique, and you investigate it on a much deeper level. 

So while I had to put an enormous amount of time and energy into becoming an expert so that I could actually teach others, becoming a teacher/instructor in dry needling and other educational content was one of the most rewarding choices I’ve made in my career.  

Not only did teaching boost my return financially and socially, it also elevated my return on my investment emotionally, ultimately giving me the confidence to open my own cash-based practice… not to mention a reputation that fed the practice and still does to this day. 


The Journey to Opening a Cash-Based Practice and Feeding the Cycle of Growth.

For those of you who are opening cash based practice, here is my BEST ADVICE:

Remember, our businesses are living systems that need to be stressed, cultivated, and fed so that they can demand growth and thrive. That can only happen when we face difficult situations and work through them.  That includes pushing growth in your clinical practice, and your business decisions.

The good news is that over time, as you accept, face, and meet new challenges, you build a confidence that empowers you with the guts to do hard things again and again and again.

Let’s face it, opening your own practice DOES take guts.

What has made our cash-based practice a huge success is that we demand clinical growth in ourselves, which adds stress to our system, but also is followed by confidence in ourselves and our decisions that translates into our clinical practice.

We’ve found that when you can tap into this type of practice standard and expectation, the benefits are endless, and result in an organically growing practice that is filled with patients who believe in your work, and trust and value the work you do together. With relationships built on these foundations, your patients become your biggest referral sources, and your therapeutic alliance with them flourishes. This feeds the cycle of getting great results, which allows patients to trust your work, which leads to your schedule book being full. All of this results in improved self confidence and therefore willingness to “put yourself out there” and stress the system down the road, ultimately allowing you to demand growth yet again.


Stressing the Business System for Growth

Actionable Tools to Build the Foundation of a Cash-Based Practice

So we’ve gone over WHY it’s important to stress your “system” to achieve personal and professional growth as a clinician, and we’ve given you a few general examples of how you can do this.

If you’re looking for some actionable tools to begin challenging yourself and producing results in your Cash Based Practice, check out this 15 min screen method.  I developed this method early on in my practice to show my value to patients, and challenge or “stress” my system – through demanding that I actually find a way to show value in 15 min.

It’s a trainable skill.  Follow the youtube video and learn how to integrate this in your practice to build your confidence, skills, and your book!

Like any valuable skill, it will be a little stressful at first, but stick with it, practice it, challenge yourself, and you too will reap the benefits.

In summary, Treat your business like a living system and you will find it will grow exponentially. Feed it, nurture it, challenge it, encourage it. For more actionable tools to make your Cash Based Practice a success, register for one of our courses at Primal University !

About the Author
Dr. JJ Thomas, DPT, MPT, CMTPT
JJ Thomas is the owner and founder of Primal Physical Therapy and Primal University, located in Bryn Mawr, PA. She is an instructor for Evidence in Motion, and lectures and speaks nationally on the topics of Dry Needling, Functional Movement Analysis, and Functional Anatomy. She has been published in IJSPT for her contribution to a commentary on dry needling and consults as a content expert for organizations such as the APTA and FSBPT. In this role, she played a large part in the addition of a CPT code for dry needling through the AMA and was on the task force that helped identify competency standards for dry needling education nationally. JJ works with US Field Hockey teams, and individuals from US Lacrosse, US Polo, USA Track and Field, NFL, NBA, PLL, MLB, and more.
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