Co-Founder, CEO Back to the Box
FROM MILITARY PT TO CASH-BASED ENTREPRENEUR
“It was in the military that I was exposed to the Functional Movement Screen and the Y Balance Test, as well as the concept of screening to decrease risk of future injury. After working in various active-duty PT assignments, including a deployment with a Brigade Combat Team to Afghanistan, I separated in 2012 and stepped into the civilian, outpatient physical therapy world for the first time. Within 6 months I tried 2 different jobs, but with both I ran into the same issue of not being able to practice with the same level of autonomy that I enjoyed in the military.”
STRAYING FROM THE INSURANCE-BASED MODEL
“I also desperately wanted a wellness/injury prevention component and could not figure out how to make that happen within the insurance-based model.” This prompted Nichole to start her own practice in Durango, Colorado
. “I love the outdoors and all that the four seasons has to offer in this part of the country."
MOVE2PERFORM: A FILTER FOR CrossFit DURANGO
“In January of 2013, I started a cash-based practice out of CrossFit Durango, basically working with
clients between scheduled classes. Those that I identify as substantial risk are further tested and/or assessed as appropriate. I was able to build a partnership with the Owners/Coaches of the gym and provide annual Functional Movement Screens for all existing members and I perform the FMS on all their new potential athletes. My business slowly grew to the point that I had to get my own space. In September of 2013, I opened the doors to my freestanding practice.
The Move2Perform software has been great for creating a filter for CrossFit and helps make sure we aren't setting clients up for failure. By making a client and the coach aware of an existing dysfunction, training can be modified to avoid loading a dysfunctional pattern while at the same time the client is working on cleaning up the dysfunction through prescribed corrective exercises.
Using Move2Perform comparison reports allow the athletes to see if their foundational movements have changed, especially if their training has changed. For example, when an athlete switches from running season to ski season or even changes their weightlifting program to accommodate an upcoming competition. Many athletes find this beneficial for performance improvement just as much as injury prevention.”
OBJECTIVE DATA FOR EARLY INTERVENTION
“I also utilize the comparison reports to highlight objective improvement beyond range of motion and manual muscle testing for my post-operative patients. Referring surgeons have expressed that this is valuable information to them and it helps justify my overall statements regarding whether or not an athlete is ready to return to sport. In one statement, the greatest benefit to the software is that it provides objective data that can be tracked over time to monitor progress or encourage intervention sooner rather than later if a decline is identified. In my current practice, the individual comparison reports and group reports are the most useful. My discharge and return to sport criteria is basically to get my patients into the slight risk category (when possible) in addition to being pain free with all their sports specific activities. All of my post-operative training programs have FMS/Y-balance included from early phase baseline testing to final criteria for discharge.”
BUILDING A WELLNESS-BASED PRACTICE
“I still have a great partnership with the CrossFit community and co-sponsor local charity/fundraising events such as races and Barbell for Boobs, but with my space I am now able to offer six, 1 hour appointment slots a day. I am building a wellness-based practice in that although I meet the majority of my new patients because they are dealing with pain/injury/surgery, I work very hard to facilitate their recovery while also educating them on the benefits of annual musculoskeletal screening to improve durability and decrease risk for future injury.”
DIRECT ACCESS, DURABILITY AND MUSCULOSKELETAL WELLNESS
“When I discharge patients they have been fully educated on Colorado direct access rights and they know they can contact me directly at anytime in the future for immediate evaluation and intervention. If I haven't heard from them, I contact them 1-3 months out to see how they are doing and to schedule a future date for their annual FMS/Y Balance Test. My goal in 3 years is to have the majority of my workday be wellness musculoskeletal screenings with interventions as appropriate and only 3-4 new patients per week.”
A CALL TO ACTION
“CrossFit is not going away, in fact it continues to demonstrate exponential growth. I believe we, as rehab professionals, have two options: criticize and yell, “Stop!” from the tracks as the CrossFit train runs us over is one option. Or,
get on board and support the athletes, coaches, and owners that do have great intentions, care about each other, and are often quite open to suggestions and solutions to improve their systems and keep their athletes safe. We, as experts in musculoskeletal health and strength and conditioning, need to step up and seize this opportunity to be a positive presence in this amazing community. Providing pre-participation movement screening is a huge first step."
BACK TO THE BOX: WEB BASED REHAB AND TRAINING
Nichole also owns Back to the Box which is a membership based website that provides post surgical and post injury rehab/training programs. “All our programs include FMS and Y-balance as part of rehab progression, return to sport, and discharge. We feature a provider network for our customers to search and find a PT near them that meets our professional standards, with the majority utilizing Move2Perform.
MORE ABOUT NICHOLE
Nichole was born and raised in South Carolina and played Division 1 Soccer at Charleston Southern University. After completing a BS in Biology she accepted a graduate assistantship at the University of South Carolina and obtained a MS in Exercise Science. During this educational experience she started exploring physical therapy as a career and graduated from the Army Baylor DPT program in 2008.
Nichole holds specialty certifications as an OCS and CSCS. She is trained in the FMS and SFMA and attended the 2013 SMFA Mentorship course. Nichole has also completed Dry Needling training with the Dr. Ma Dry Needling Institute. When Nichole is not working, she can usually be found at CrossFit, on the trails, rivers, or slopes in Colorado.