The Thinking Practitioner Podcast:
Episode 60: Physical Therapy Assisting and Massage with Matt Gavzy

Whitney Lowe:

Welcome to the Thinking Practitioner. This episode is sponsored by our wonderful friends at Handspring Publishing. Their catalog has emerged as one of the leading collections in professional-level books written especially for body workers, movement teachers, and all professionals who use movement or touch to help patients achieve wellness.

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Whitney Lowe:

This is Whitney Lowe, and welcome to the Thinking Practitioner. Til is off this week, and I'm joined by my good friend and colleague Matt, Gavzy, and we're going to have an interesting conversation on working in integrated healthcare environments. Matt, welcome to The Thinking Practitioner.

Matt Gavzy:

Thanks, Whit. How are you today?

Whitney Lowe:

I'm doing very well. Matt, if you will, take a few moments and let our listeners know a little bit about your background. We've known each other for... I was trying to count back the number of years. It's been probably too many to count now, but quite a while. But tell everybody a little bit about your background and what you're doing in the massage world now.

Matt Gavzy:

Absolutely. I was originally a massage therapist. I still am, but I've been doing that since 1994 when I got my board certification. I did the typical stuff, opened my own practice and everything else. In 2004, I put myself through physical-therapist assistant school, and I've been working as a PTA since then. I still have my private practice, but a little bit more focused on the physical-therapy world, learning a lot, doing a lot of work in subacute, long-term care settings, as well as currently I'm in an outpatient orthopedic setting. It's really great that I have a boss who embraces the backgrounds that I have, the varied backgrounds in terms of working, doing massage therapy, and doing physical therapy as well.

Matt Gavzy:

Currently, I am working on new continuing education classes. I have one out now, Orthopedic Procedures and Postsurgical Precautions, and I've been traveling around a little bit with that. Currently, I'm working on putting together a class for what I would call Rigid Taping Techniques. Right now, the big thing is using Kinesio tape or kinesiology tape, but I believe that there still is a place in the physical therapy and massage-therapy world for what might be termed McConnell taping or Mulligan taping techniques, where you're using more rigid taping, like a Leukotape type of product, to be able to stabilize joints better. I'm putting the finishing touches on that, and I have a few other classes that I have in the works as well.

Whitney Lowe:

Great. I want to dive into a number of those things that you mentioned there, but let me sort of go back to some of the beginning and earlier parts there. What sort of drove you to want to explore going to PTA school after you were already a massage therapist? Were you sort of looking for something else to do or wanting to enhance what you were doing in your massage career? What sort of drove that decision?

Matt Gavzy:

I believe what, really, it was, was for me, in my practice at the time, I was noticing that massage, where I was and doing what I was doing, was kind of unstable, lots of different things going on in the economy at the time, and what I was really doing... As much as massage therapy is healthcare, I think if people had the choice between a massage and paying their mortgage or paying some of their bills, that massage would take a backseat to it. I wanted to find something that was a little bit more stable, and I found that I thought being a physical therapist or a physical-therapist assistant was actually much more in line with the massage-therapy work that I was doing at the time. I was- the orthopedic massage that I was lucky enough to work with you on, sports massage, some pain-management stuff. It really seemed to be a much more logical extension for me at the time of what I was doing. That's really where it went.

Whitney Lowe:

Yeah. Tell me, with your current work environment, in sort of a day-in-the-life sort of thing now, when you do clinical work, are you working specifically as a physical-therapist assistant who does miss massage, or you specifically working as a massage therapist who also does PTA work or do you blend them together? How does that work in your work environment? Well, first of all, and if you will tell me about your work environment. Where are you actually doing this stuff now?

Matt Gavzy:

I work at a facility in Teaneck, New Jersey called Churchill Orthopedic Rehabilitation. It's a sole practitioner-owned practice. It's not associated with a corporate entity around here. There's a number of corporate entities, like Ivy Physical Therapy or SportsMED or SportsCare, that are much more corporate-owned and much more numbers-driven. It's more about being a high-volume type of facility. The environment I'm in is really wonderful. We are out-of-network, so we don't have to see as many patients. Rather than in a typical, high-volume type of facility, they'll see four patients an hour, much like when you go to your doctor's office. Here, we book to an hour with a break. I might see a patient at 9:00 AM and then 9:30, and then I have a built-in break into my schedule at 10:00. It gives me time to really get to know my patients. It gives me time to build relationships with patients, which I think is really at the forefront of where medicine should be in building relationships with people and not just looking at them as a diagnosis or a body part. I think that that's really good.

Matt Gavzy:

I get to do a lot of hands-on because I'm not having to see so many patients in a day. I'm a physical-therapist assistant there whose boss enjoys the fact that he has the ability to look at the body with a different set of eyes. Typically, a physical therapist will look at the body with what I term looking at it from a mechanical problem or a mechanical-derangement issue, whereas we as massage therapists look at it, I think, from a soft-tissue perspective first. I'm very fortunate to have a boss who allows me to use my other set of eyes, as you might put it, to be able to look at the body and say, "You know what? Maybe it's not just a mechanical derangement, or maybe this is not a mechanical derangement at all, and it's really more of a soft tissue problem." He allows me to explore that world and try to help my patients the best I can.

Whitney Lowe:

In the work that you do when you're seeing a patient, are you... You said you're doing some type of soft-tissue work. I'm curious about this because I heard this comment on another podcast a week or two ago, and this was similar to my experience of having worked in a couple different physical-therapy clinics in the past. Are you doing the type of massage work that a massage therapist would be familiar with when you do soft-tissue work, or is it more a patient fully clothed, just a few minutes of doing some things, or are you doing regular type of massage-treatment techniques that a massage therapist would recognize?

Matt Gavzy:

I'm using a lot of the techniques that we as massage therapists are familiar with, but I'm not doing it in that massage environment where the patient is on a table, undressed to a level that they're comfortable with, and then under a sheet. They're clothed. I may be able to expose a body part in terms of lifting a shirt, rolling up a pant leg, or if the patient's wearing shorts, but it's a much more physical-therapy, clinical environment than it is a massage-therapy environment.

Whitney Lowe:

Yeah. Do you think that has any impact on the outcomes that you get with the people that you're working with, for example, that you could do something different with them? Again, this will be individual by each particular patient, I recognize, that you're working with. But as a general rule, do you think that would make differences if you were spending more time with them in a traditional type of massage environment with the soft-tissue work that you do, or does that feel like it's getting the kind of results that are ideal in both those kind of situations?

Matt Gavzy:

I think you're right in that it depends upon the patient. There are definitely days and times when I wish I had more time to be able to really put my hands on somebody and really let them do some exploring and see what's going on. I don't get to spend as much time doing that. As we know, when there's a soft-tissue issue someplace, it's very likely that it can be coming from somewhere else so that I have to spend... I don't have the time to always explore that, so I have to spread that out over a number of sessions with a patient. But there are definitely times when some really good, targeted massage-therapy techniques that physical therapists don't know can definitely start the process and move things along quicker. There's no question about that.

Whitney Lowe:

Yeah. One of the things that I felt in working in that environment was similar to what you were saying there, that in many instances, there were times where I felt like, "I really feel like I could get more done if I could do more comprehensive, soft-tissue massage work worked like I was trained in doing with this particular patient," and then on the flip side of that is the recognition that this is a person who's getting soft-tissue treatment who never would have gotten it before. Their introduction into that, in that particular environment, along with the other things that they're doing is a significant aspect of moving forward with their progress. There's pros and cons, I think, to any of those kinds of situations, but I do think introducing it in that kind of environment can really be helpful for so many cases.

Matt Gavzy:

Absolutely. The physical therapists, or at least the schools that are around here in the East Coast, the therapists that I've talked to say that they made get eight hours of massage maybe in their entire educational career, and then usually they're given a caveat of, "Don't do too much manual or too much massage therapy because then your patient's going to expect and want that every time they come in." My attitude is, "Well, if it's appropriate, why wouldn't I be doing it?"

Whitney Lowe:

Yeah. That's a very interesting kind of concept along with training because then I had... I was really surprised when I learned that as well, many years ago, about what a small quantity and amount of training that many of the individuals have in soft-tissue manipulation in that particular area. Their training focuses on lots of other things associated with the rehab environment, but it's something that I think we have to remember as we're trying to break down some of these silos and communicate with other health professionals that there's differences there.

Matt Gavzy:

Absolutely, there are. For me, the number-one reason that I think people go to physical therapy, or a good part of that, is that they want that hands-on experience with their therapist. They want to be touched. We as massage therapists know that the oldest form of therapy is touch. I sometimes think that other healthcare practitioners have forgotten that. I remember being a kid and falling down and scraping my knee off of a bike, and then you run home. Mom or Dad is there to clean up your scrapes and your bruises a little bit. They give you a hug and a kiss, and everything suddenly seems great. You're ready to go out and conquer the world again with your friends. I think that's something that we as massage therapists, we remember, but I think the other healthcare practitioners have forgotten that. I have found that a large portion of why people come into physical therapy is for that touch. I think that I'm very fortunate that my boss allows me to explore that and use that. We do get some very good results from doing the massage therapy there.

Whitney Lowe:

Yeah. How is your work perceived by the other members of your healthcare team there? Are they all pretty supportive of what you're doing and the approaches that you're taking with those patients, and do you all have a good sort of integrated networks team approach there?

Matt Gavzy:

We do. We're good. They respect what I do. They respect the education that I have, the time in that I have doing massage. They've seen me do some things, and they've come up to me and said, "Hey, that looked pretty cool. What was that you were doing?" I do spend time educating them on massage, and at the same, I'll watch them as they're working with patients and seeing what techniques they're using for... not manipulations, but mobilizations and things as such and different exercises. My environment's a really nice, integrative environment to work in. It's very hands-on. It's very open. Even the floor concept is an open concept. There's not separated rooms or tables that have a lot of the curtains that get drawn. We get to see everything in an open pattern. We get to watch the patients work. We get to see the other therapists work. I don't think that there isn't a day go by that I don't watch and learn from my colleagues.

Whitney Lowe:

Yeah. Yeah. I was in a clinic that had a very similar type of environment like that, and I thought that was really fascinating of being able to see what other people were doing in those kinds of processes, and for learning from each other, and as a matter of really breaking a lot of those silos down to really see, "How can what I'm doing better support the work that they're doing/" I would assume, is this also true in your environment, that, for example, you are often seeing the same patients at different stages for the different types of things that you're doing?

Matt Gavzy:

Absolutely. Absolutely. Since I can't do an evaluation, the physical therapist will do the evaluations. At some point in time, as their case load gets filled up, they need to let go of those patients and give them over to me as an assistant, but they always have eyes on, and notes are being written. We still do progress notes and reevaluations and everything else. They definitely know what's going on with what I'm doing with their patients. If I have questions and I'm saying, "I'm not quite seeing something. I might be missing something. Can you come back and take a look at the patient?" or, "Can you put them on your schedule for this day, and I'll see one of yours?" just so that we're doing what's in the best interest of the patient and moving them forward so that they can get out of the clinic.

Whitney Lowe:

Yeah. Yeah. I want to go back a little bit to something that you were saying early on in your introduction too. I know you and I have talked about this quite a good bit, that you're doing some courses now to introduce massage therapists more to the concepts of postsurgical rehabilitation and preparations for surgical procedures and things like that. Do you think it's important that massage therapists know and understand some of these surgical procedures more significantly? Because a lot of times, that goes outside of our scope and attention when somebody starts talking about surgeries. But a lot of times, since people are coming in having had some of these procedures, it does seem like there could be some benefit in learning a little bit more about actually what is done during the procedure.

Matt Gavzy:

Absolutely. What I find is that the patients have no idea what's happened to them. They go in for a procedure, a hip replacement, or a rotator cuff surgery, they have no idea what's gone on underneath the skin. All they see is a scar and a bandaid or a bandage or whatever, but they know they're in a lot of pain. They're lost. I think educating them is really important, but I think educating us, as massage therapists, as we would like to continue to move the industry forward or become more mainstream with those other complementary healthcare providers, I think it is important for us to know what is going on because I know a lot of massage therapists who want to see these types of patients, who do see these patients, but they have no idea of really what's gone on beneath the skin.

Matt Gavzy:

They don't know why, "Okay. Well, if this person had a knee replacement, why are they still swollen three months later?" In the physical therapy world, I would expect somebody's knee to still be swollen three, four months after a knee replacement or a hip replacement or something, and to understand what's really happening underneath the skin, that even in a hip replacement, if somebody's having an anterior approach to it, what we would call an anterior approach, even though the muscle may not be cut, they're using retractors and moving those tissues out of the way, the muscles out of the way so that they can get to the joint capsule and cut that away and then work on the bones and everything and do what they need to do.

Matt Gavzy:

That is still trauma. That's a lot of trauma to the soft tissue that, as massage therapists, we can absolutely affect, no question about that. But by the same token, we need to know what that surgery was and how the doctor wants us to be able to work with that patient so that we don't endanger their surgery or possibly dislocate something or put the patient into more pain or even set them back, because we can set somebody back if we're not careful in what we do as massage therapists.

Whitney Lowe:

Yeah. Tell me a little bit about that, because my experience in working with massage therapists, mainly because of the things that are told to us in our entry-level training, really sort of warning us away from getting involved with surgical cases of any kind... What kinds of things can you tell the average massage therapist in terms of greater awareness or how to develop a greater awareness of some of these kinds of procedures? What are some of the big cautions that people would want to be careful for after seeing seeing a client in a postsurgical case?

Matt Gavzy:

I think the best thing that we can do is to reach out to... If the person was referred to us by a physical therapist, I think we should be reaching out to the physical therapist or we should be reaching out to the surgeons, the orthopedists, and really understanding what it is that they put on as precautions and protocols. I know when we do somebody who has what would be called a posterior hip replacement, there are definitely things that we don't want the patient to do for the first number of months. The doctor is the one who decides at what time those precautions will be lifted, but we definitely don't want the patient to be bending over to touch their toes or, by the same token, lifting their leg too high to put on their shoe.

Matt Gavzy:

We don't want the patient to go pigeon-toed or internally rotate that surgical hip. We have to watch out how the person turns when they walk. We also don't want them crossing over their legs, even at the ankles, or going into too far of adduction because those are positions in that approach that can cause the hip joint to dislocate, that new surgical hip to locate. What does that mean for us as massage therapists? Well, we want to make sure that we get them on and off the table safely. A good log-rolling technique works well with that type of patient. We may not be able to place them on that surgical side yet. It just may be too sensitive for them, making sure that we are using bolsters properly and keeping their knees apart.

Matt Gavzy:

We want to make sure that when we do our range of motion, that we don't bring the knee to the chest so far because clearly would be breaking that 90-degree rule. Typically, "Okay, let's give it a good stretch in that hip. We'll bring that knee to the chest," and you can pop somebody's hip, or if you're doing internal and external rotation of the hip as just your regular course of what you would do during a massage, we need to be more aware of the positions that we put our patients into, our clients into, and then understand, "Okay, does that make sense with what the patient is coming here for, with their comorbidities, their surgeries, and things such as that?" It works the same way with a shoulder.

Matt Gavzy:

If somebody's had rotator cuff surgery, the doctor may say, "No forward flexion above 90 degrees for a period of time," or, "No external rotation past 30 degrees." Typically, if you're going to pick up somebody's arm and lift it up over their head to maybe expose the triceps to work, you could very easily be violating those precautions and protocols that the doctor is setting forth. We need to be able to adapt, we need to be able to overcome, but I think we also need to really educate ourselves on what those things are.

Whitney Lowe:

Yeah. I don't tend to see a lot of educational programs either in our entry-level programs and in the CE world, in our field, talking about this issue very much. To me, this sounds pretty important for the people who are working with clients who may have had a surgical procedure, knowing, "How long after the surgery is some of this kind of stuff okay?" or, like you mentioned, knowing that you shouldn't engage in certain types of even gentle range-of-motion activities within normal range, not trying to push it really far to the end of stretching something, but just certain movements shouldn't be done at a particular point. It seems to me like this is some pretty important information that we're missing in a lot of the educational programs that we might be needing to put in there. Would you say that there's any beneficial way that for a massage therapist to learn more about this at the outset?

Matt Gavzy:

From the outset, it's hard, yeah, because I don't know of personally... I can't say that there aren't any, but I don't know of any programs specifically that talk about these things in their entry-level programs. I don't even know how many other massage therapists have really taken the time to study these types of things. I know that they're out there. I know they're out there because they're doing some great work. But in terms of an entry level, I'm not sure about that, and I think more classes, more programs...

Matt Gavzy:

I think it's something that should be taught in an entry-level program, whether the school brings in somebody to do a program as an adjunct, a one-day, "Hey, we're going to bring in this guy because he's got some really good information, and we think that it's important to know as part of our orthopedic training," or whatever programs they're working with. I would definitely like to see this out there more and more. As this industry tries to move forward, I think we do need to up our education. I think that the education level that a PTA gets, let alone a PT, is definitely more in-depth and more varied, definitely more varied than what a massage therapist gets.

Whitney Lowe:

Tell me about this, because I think a lot of our listeners may not be aware, and I'm not even aware myself, of what the educational requirements are for a PTA. Maybe, also, can you explain a little bit, because I know there's a fair amount of confusion sometimes about the difference between a physical-therapy assistant and a physical-therapy aid, and what kind of educational requirements are there for each one of those different positions?

Matt Gavzy:

Yeah, I'll take that even a step back for a moment. A registered physical therapist is typically, currently, the... All of the schools in the United States are working on DPTs, doctorates of physical therapy. They're three-year postgraduate programs. They are clinical doctorates. The education level is very extensive, and they get at least three or four affiliations. They try to put those affiliations into different environments, subacute long-term care centers, pediatrics, outpatient orthopedics, acute-care hospitals. They try to give them a varied type of education. A physical-therapist assistant, at least in the State of New Jersey, where I am, is an associate's degree. It is a two-year program, and we get a lot of the education that the physical therapists get. We do have in-depth pathology classes. We do learn and about modalities, e-stim, ultrasound, fluidotherapy, diathermy, going way back. We do a lot of that, and we also get a lot of affiliations as well. We probably get at least three affiliations in our education to try to give us as much hands-on in as many different environments as we can get.

Whitney Lowe:

When you speak of affiliations, you're talking about the sort of subspecialty areas that you were mentioning a moment ago of-

Matt Gavzy:

Yeah. You actually go out into those environments. Yeah.

Whitney Lowe:

Okay.

Matt Gavzy:

You're actually going out into a hospital, you're actually going out into a subacute facility, and you're actually doing hands-on physical therapy. You are working with the patients. You're working how to time management. You're working on your note-writing skills, all of those types of things. I guess the best term for it is on-the-job training, but still with the safety net of the school and the education behind it. Not quite as intense, but it can be very... Submersive is, really, I think a good word. It puts you into the environment. The good part is that it gives the physical therapist or the assistant an understanding of, "Is this the environment that I want to be working in?"

Matt Gavzy:

Then a PT aid... Well, let me also say that I know in some states a physical-therapist assistant is only just a certification program, so it's not even an associates program. They have it set up with so many hours. Each state's scope of practice is going to be different. Here in New Jersey, I have the ability to do everything that the physical therapist does. What I'm not allowed to do is I'm not allowed to do an evaluation, right? I'm not allowed to technically write a discharge or write certain evaluative statements on a discharge, although I can absolutely do a lot of information-gathering, whether there are special orthopedic tests, whether it is manual muscle testing, goniometry, range of motion, end feels, things like that. I have absolute purview to that. I can use all modalities, right? But I'm still supervised by the physical therapist because they are the ones who set out the plan of care. Okay. I can ask a therapist-

Whitney Lowe:

Excuse me, just a second. I didn't want to interrupt you, but I want to clarify too, as a physical-therapist assistant, would you ever be in private practice by yourself without an association with a physical therapist, or are you always going to be associated with a physical therapist in some environment there?

Matt Gavzy:

No. I must always be associated with a physical therapist because they must oversee my patients. They must oversee my caseload. As a matter of fact, they co-sign my notes. I write my notes. They go back, and they look at the notes and make sure that everything is proper. Then they co-sign them and sign off on them, saying, okay, what I've done is proper and appropriate for this patient at this time in their rehab cycle.

Whitney Lowe:

Yeah. Is that structure of the system with physical-therapist assistants consistent... Do you know if that's also outside the US, Canada, Australia, UK, Europe... Is that the same sort of system, that there are assistants working directly under the physiotherapist in those other countries as well, or is that different?

Matt Gavzy:

I have to be honest with you. I don't know if those other countries have assistants. I really, really don't know the educational systems and whether or not assistants are utilized in other countries or whether they're just straight physiotherapists or registereds.

Whitney Lowe:

Yeah. Okay. You were about to talk about the physical-therapy aid.

Matt Gavzy:

Yeah.

Whitney Lowe:

What is the difference between the aid and the assistant?

Matt Gavzy:

The aid is just a tech, a facilities assistant. They're only allowed to technically set up equipment for somebody. Part of the plan of care is that the patient is going to do biceps curls with five pounds for three sets of 10. The aid is allowed to get the weights for the person, give them, but they're not allowed to give them any type of corrections at all. Their job is really supposed to be just about setting up equipment, taking care of the details, making sure equipment is cleaned, wiped down, making sure that equipment is turned turned on. They're not allowed to touch any of the settings. In the State of New Jersey, technically, an aid is not even allowed to put on an ice pack or put on a hot pack.

Matt Gavzy:

The assistant or the registered has to do that because that is considered a skill because it's knowing where it's to be placed. It's knowing and checking for possible skin reactions afterwards, whether it's burns or frost bite, too cold. Their job is really to assist in setting up equipment and saying, "Okay, what's next?" and then moving the patient through their program, but it's still up to the assistants and the registereds to have eyes on and hands on. If I'm watching somebody and I see that they're not doing it properly, it's really incumbent upon me to go over and make the correction, because that is, according to scope of practice status, part of the skill in physical therapy, understanding mechanics and corrections that should be made to keep the patient safe.

Whitney Lowe:

Yeah. I'm curious to know too, with your experience, both working in this environment and also being trained as a physical-therapist assistant, and the years that you spent working in conjunction with them, has that changed the way you approach anything in your massage therapy work in terms of soft-tissue work with either techniques, methods, or things and principles that you've been exposed to? Has that changed your work as a massage therapist at all?

Matt Gavzy:

Absolutely. Absolutely. It's allowed me to marry the two worlds. In my private practice, it allows me to look at the body differently. I can say, "Well, okay, if it's not this, then what about this?" Even though I'm not diagnosing a patient... I'm not allowed to do that as a massage therapist. I'm actually not even allowed to diagnose as a physical-therapist assistant, but the knowledge that I have allows me to definitely see the body differently, so I can look at it. It allows me to work and change my massage therapy plan of care on the fly, because if I can notice that something is not working or if I'm working on one body part and they're saying, "Hey, last time when you did this, I noticed this," I can kind of switch hats for a moment and say, "Okay, what are we looking at?" but it also allows me... I think the greatest benefit is that it allows me to really know if I can help this patient or if what I'm doing as a massage therapist and what they need would be out of my scope of practice.

Matt Gavzy:

In that case, then I can say to the patient, "Okay, this is what I think I'm seeing," or, "This is what I am seeing. You know what? I think you need to either go back to your doctor," or, "You know what? Let's bring you into the physical therapy clinic, and let's get a different set of eyes on here, because what I think I'm seeing is not necessarily going to be helped by a massage. I can help definitely alleviate some of the issues, but some of these things that you're presenting with, I think, are going to be outside of my scope. I think I need to refer you out to somebody else." I think it allows me to understand my scope of practice better, but I definitely have the ability to marry the two knowledges, the two worlds together, as you like to put it, and I think it helps my patients better.

Whitney Lowe:

Yeah. I get a lot of questions from massage therapists looking to say, "What's next in my career?" or, "I want to kind of expand what I'm doing past just the kind of work that I've been doing one-on-one with massage clients for a number of years. Should I go back to school and become a physical therapist? Should I become a chiropractor? Should I do this?" Do you think there's a significant advantage, both career-wise and professionally, to expanding your scope and skills and maybe even earning potential and that sort of thing for massage therapists to pursue something like physical-therapist assistant training?

Matt Gavzy:

I think that's a great question, but I also think it's a question of, "What does that person really want to do?" If they're feeling like they're stuck in massage, and they are like, "I really like the idea of doing something more," then I think exploring being a physical-therapist assistant or a physical therapist or a chiropractor is a good thing, but I also think that there's a lot of ability to take courses just in general and educate ourselves on things. To me, knowledge in and of itself is not bad, and knowledge is always good, but I think it's how we apply that knowledge that can take us out of our scope. I know people who love neurology stuff, and they bring that knowledge into their massage work. They're fantastic at it, but they also know then, "Okay, if I'm seeing this, then this is outside of my scope, and I really shouldn't be doing something with this person as a massage therapist. I should really be referring them out to a neurologist or something."

Matt Gavzy:

Do they need to go and become a physical-therapist assistant or a physical therapist or a chiropractor? I don't know. If they're looking for a career change, yeah. The great part is that massage and soft tissue knowledge will always be there because we are the soft tissue experts, even the physical therapists that I talk to, my boss especially... People will come in and say, "What's Steve's expertise?" and I think his expertise is in shoulders and somebody else is really good in backs or the McKenzie technique. Somebody can in and looked at me and said, "Well, what's your specialty?" My boss, from the office, just yelled out, "Soft tissue. That's what he does well." It was a nice acknowledgement from him that there is a place for a massage therapist in this world, in his world to be able to do that type of work. But I think if somebody wants to become a physical therapist, absolutely. Go ahead. That soft-tissue knowledge is not going to go away. You'll always be able to use it. You'll always be able to apply it.

Whitney Lowe:

Great. Well, I want to sort of ask you one last thing as we're wrapping up here too, if there's been any kind of real memorable cases where you saw the blending of those skills together really being particularly advantageous for you, of anything that comes to mind that's like, "Having both those skill sets was a really significant advantage in making good clinical change," in any cases that come to mind.

Matt Gavzy:

Yeah. Yeah. As a matter fact, I've got one that I'm working with right now. Without being without divulging too much, an older gentleman in his 70s coming in with low back and gluteal pain, and he was working with a therapist for a number of months. I would probably say a solid five or six months. Then the therapist decided to take another position someplace else, and this person got on my caseload. Then over time, I was able to look at things different, definitely from a more soft tissue, because he wasn't presenting with those classical mechanical derangement type of symptoms and the classical physical-therapy approach wasn't working. I said, "All right, so let's start looking at this from a more soft-tissue perspective," and I did. I started working more on his hips and hamstring length and just soft tissue in general.

Matt Gavzy:

Now, the patient comes three times a week, so I would say within the first two weeks, I could see some real changes. Posture was better. Walking was better. The patient was telling me that they were able to sit at their desk longer and when they stood up, they weren't quite so stiff, ability to do gardening better. I worked on their home-exercise program and made sure that he was as compliant as possible. Yeah. That's a nice case that stands out where going the traditional route just didn't work and going with the soft-tissue route, the massage-therapy route absolutely did. Even the supervising physical therapist looked at me and said, "That was a really good catch to kind of change gears and do that." It was a nice feeling.

Whitney Lowe:

Yeah. Great. Well, Matt, thank you so much for delving into some of these topics with us here today. I think there's some interesting insights that I think we can all develop from learning more about other professions and learning more about what other people do. I think we're kind of at the stage of a bit of a paradigm shift of starting to break down some of those silos that have existed between these different professions. I think seeing people like you doing crossover of working in both those fields is certainly advantageous. Thanks so much for sharing that with all of our listeners here today. It's been great talking with you about that. I would like to also say if you've got any particular ways that people can get a hold of you, find out more about the courses that you're doing and things like that, where can people learn more about you?

Matt Gavzy:

Absolutely. My email address is bodyworkingsmt@gmail, so it's B-O-D-Y-W-O-R-K-I-N-G-S and then M as in Mary, T as in Tom at gmail.com. My cell phone, you can always reach out, text me, call me, is (201) 410-7855. I am currently working on my website. That's got a bunch of my energy at the moment. I'm trying to get that up and get my educational stuff up on there.

Whitney Lowe:

All right. That sounds good. Well, thanks again so much for being with us here today, Matt. It was great talking with you about this.

Matt Gavzy:

Thank you for giving me the opportunity. It was a pleasure.

Whitney Lowe:

Absolutely. I would like to thank all of our listeners for joining us here today, and also to our sponsors for the podcast. Books of Discovery has been a part of massage-therapy education for over 20 years and thousands of schools around the world teach with their textbooks, e-textbooks, and digital resources. In these trying times, this beloved publisher is dedicated to helping educators with online friendly, digital resources that make instruction easier and more effective in the classroom or virtually. Books of Discovery likes to say, "Learning adventures start here," and they see that same spirit here on The Thinking Practitioner Podcast. They've been a proud sponsor of our work ever since the beginning. We share the mission to bring the massage and body-work community enlivening content that advances our profession. Do be sure to check out their collection of e-textbooks and digital learning resources for pathology, kinesiology, anatomy, physiology at booksofdiscovery.com, where Thinking Practitioners listeners can save 15% by entering THINKING at checkout.

Whitney Lowe:

We would like to say thank you again to all of our sponsors and also to the listeners for taking some time to hang out with us here today. You can stop by our sites for show notes, transcripts, and any extras. You can find that on my site at academyofclinicalmassage.com and also over on Til's site at advanced-trainings.com. If you have questions or things you'd like to hear us talk about, please email us at info@thethinkingpractitioner.com, or you can look for us on social media. You can find Til at his name, @TilLuchau, and also mine @WhitneyLowe on social media as well. If you will, please take a few moments to write us on Apple Podcasts, as it does help other people find the show, and you can hear us on Spotify, Stitcher, Google Podcasts, or wherever else you happen to listen. Please do share the word and tell a friend. Thank you again for listening, and we'll see you again on the next one.