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Hey, welcome to Podiatry 
practice Mastery done here. 

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What I'm going to be including 
here in just a minute or so is a

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explanation. 
It's part of a lecture that Paul

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hobro gave about Shockwave and 
specifically how to explain 

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Shockwave to patients. 
I think you're going to like it,

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it's about an eight minute 
segment because I couldn't take 

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his whole lecture, but these 
same questions that he goes 

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over. 
I've included them in my patient

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presentations, so if you want to
go get My patient, presentations

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tool, it's on Podiatry, practice
Master e.com, just put your 

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email in there, go to the 11, 
plantar, fasciitis, or achilles 

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tendonitis. 
You're going to see the same 

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questions that he asked. 
They're included in these. 

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These slides that I use for each
of my patients, use them but 

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here at listen to see what Paul 
has to say. 

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And if you want to learn more 
about Paul hell, bro, I'll put a

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little link underneath this 
episode so you can learn more 

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about him. 
Okay. 

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Thanks guys. 
With that, you go to be quite 

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engaging when you do it. 
So I didn't think about at this 

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stage, making everyone really 
uncomfortable and say, I want to

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write down how you would explain
Shockwave do. 

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I was going to get someone to 
stand up and say it, but I'm 

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going to be kind to you because 
that's, that's one of those 

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things. 
So, irritating, the speaker does

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it? 
But I will say that when a 

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patient is to me. 
So what is Shockwave? 

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I say, it's a, he Healing 
modality, there's probably going

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to speed up your heating by 
about 50%. 

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It's got an 82 percent success 
rate and what we can do is 

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supercharge your healing, your 
body May well. 

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Have storage is like a 
defibrillator. 

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When you restart the heart of 
defibrillator, restarting the 

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natural healing processes but 
only we're going to restart it. 

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We're going to ten exit and 
we're going to end up with you 

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being back. 
Doing the things, you love far 

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quicker than if you don't use 
it, it's going to double the 

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cost of treatment so it's up to 
you whether you decide to write 

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There's no work best as I can, 
to help you get to where you 

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want to go. 
Then when I say, what about EMT 

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t.i. 
So, this is an add-on because we

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can kick-start your healing 
process for me speed, the whole 

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thing up. 
But if we do the MTT, we're 

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going to reboot yourselves, just
like your own laptop which when 

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you reboot, it starts to go 
faster again if we reboot those 

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cells and then we zap them. 
This then everything is going to

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work so much better, and the 
combination is great. 

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Greater than sum of its parts. 
And those rcts, two of them, 

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proved that Shockwave versus 
Shockwave an EMT tee shot. 

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Wavy MTT outperform Shockwave on
his own. 

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So we've got signs to prove 
that. 

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So in TT, reduce pain 
inflammation. 

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Optimize the cell radio pressure
wave to the surrounding tissue. 

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He swt treat the underlying 
pathology and exercise therapy 

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to treat the cause of the 
injury. 

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Hopefully that landed yesterday.
I'm not just about Out treating 

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the little bit because frankly, 
anyone can do that, if you've 

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got enough money, you could buy 
a machine, you can stick it on 

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the bit that hurts and you can 
treat and successfully the 

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person walks out. 
And you've got rid of that 

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mythology, big fucking where. 
Well done you, what's happening 

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with the human body? 
Then what have you done? 

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You just giving them three to 
six months for they got to come 

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back in again as you fix them. 
So this becomes a really 

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important element. 
So how do I achieve two friends 

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to each other? 
So I got my patient coming in. 

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I consider him a friend. 
Yeah, and I've got Shockwave 

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over here. 
This is one of my best friend's.

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I want to try and get those two 
people to enjoy each other's 

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company. 
So step by step approach to 

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Patient engagement, ethics and 
concordance. 

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Now, concordance is a huge word.
Okay, concordance means that 

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it's not the doc say, this is 
what you need, and they go. 

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Okay, concordance is when you 
educate a person and have an 

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opportunity, to make a decision 
based upon what you've told 

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them, what they've learned and 
what they've understood. 

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And if they're making the 
decision, they are far more 

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likely to engage those. 
You've got staff. 

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If you walk in one day and go, 
by the way system that we work 

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on is all change and it's now 
this they're buying minimum. 

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If you think is the problem 
we're going to work together to 

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find a solution. 
I was on board by the time that 

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solution is because they all 
involved in the process. 

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If you don't involve the patient
in the process, you're just 

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doing something passively to 
them. 

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And they're hoping that it might
work when you educate them 

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there, then on board and then 
they get involved, and then they

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get great outcomes and by the 
way, that really have to pay for

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it. 
So how do we introduce? 

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We educate them. 
First of all, you've got to 

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achieve a diagnosis, right? 
And you going to demonstrate 

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that to your patient, the 
easiest demonstration the world.

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World is when someone has ITB 
friction syndrome. 

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Iliotibial band runs down the 
side of the leg there. 

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It's origin is at the tfl and 
the group Max and you can put 

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them inside line. 
And you can do what's called 

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overs test, which is a pretty 
average test. 

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But it's very, very easy. 
If you put them in a position 

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for the ogres test, their knees 
should drop and hit the couch. 

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Yeah, if it doesn't, it's 
hanging in midair and you can 

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measure one, two, three, four 
fingers, a whole fist to fist 

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distance from the couch and you 
Patient. 

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You can see very very easy. 
There lateral knee. 

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Pain is coming from there tfl. 
And if those of you that don't 

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have great, anatomy and 
physiology. 

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If you got some sexy jeans on 
today, if you just decide your 

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right pocket there's a little 
pocket. 

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We used to put coins if you put 
two fingers into your coin 

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pocket and you push down, that's
where your tfl is. 

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That's where most of lateral 
knee pain comes from? 

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Because that gets time, the IT 
band has a tensile strength of 

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steel. 
You can foam roll it, you An 

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shock wave at. 
You can do any kind of 

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percussion device on, it isn't 
going to lengthen. 

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The only thing that's going to 
change that, is that the tfl? 

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So, when we do a little bit 
trigger point on the tfl, and 

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the patient sees, their knee, 
drop into the couch, it's like 

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the lights from them. 
We've achieved some, they can 

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see that you can test and 
measure diagnosis. 

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Some of these really easy test. 
The patient can see and buys 

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into the do 5 single leg. 
Squats, get back on the capsule.

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Tightened up again. 
We haven't achieved anything 

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we've done is Hampton. 
Stand. 

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We then must give them options 
as I'm going to go through how I

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give options about What 
treatments they might have. 

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Let me go and give them an 
opportunity to decide this for 

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the ethics, come into it. 
I've educate, you about 

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Shockwave, I think it'd be a 
great treatment options. 

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You have made it as one of my 
three options for you to decide,

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but I'm not going to sit there 
silently. 

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What you want to do? 
You want to go through this now?

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So I explained to you in a 
second, how you give that bit of

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Time bit of delay to give them a
chance to think about what they 

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want to do. 
And this is really important to 

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me from an ethical point of 
view. 

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Stay focused on the patient is 
offering the modality that only 

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or best option as an 82 percent 
success rate. 

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So you will struggle many times 
to convince me that it's not 

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their best option, but isn't 
their only option, are we going 

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to leave them destitute and able
to feed their kids or heat their

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house? 
Because we talked them into 

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this. 
Yeah. 

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So we've got to think about what
the options are they? 

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You could have. 
So the way I introduced my 

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patient to the process of let's 
call it a Pall over meant they 

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could. 
It sounds good. 

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And I asked three questions. 
They come in. 

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They say, my knee pads. 
Keep it simple. 

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I said what the three things you
can't do, as a result of this 

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knee pain and they wrap them off
and that goes in my notes. 

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So, I can't bend down to pick up
my baby when they're crawling 

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around the floor. 
I can't run actually, I'm 

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struggling to do my job in a 
three, pretty big things. 

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Yeah, so what your three goals 
when you're pain free, if we're 

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successful working together, 
what the three goals you would 

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like to achieve And it might be 
run. 

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I want to run the Chicago, 
marathon. 

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It might be that. 
I want to be pain free and not 

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feeling like a 90 year old when 
I'm only 35, it could be all 

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sorts of things, but then their 
goals, you write them down. 

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And guess what? 
You refer back to these at the 

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end of your secrets. 
Of treatment with them or maybe 

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another month on top of that and
you say, these are the three 

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goals. 
You said to me a couple of 

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months ago, how we doing on 
those?