In today’s episode, we are sitting down with Dr. Hays Estes of Premier Physical Therapy & Sports Performance. We kick off the discussion by delving into Dr. Hays’ journey and exploring what it takes to get into PT school.
We also got the chance to uncover his personal motivations for his career in physical therapy and how his own injuries have not only made him stronger but also empowered him to empathize with his patients.
Dr. Hays takes us behind the scenes of his practice, Premier Physical Therapy and Sports Performance, and shares how his approach has evolved over the last five years.
Listen to the podcast episode here!
I don’t know if I told you this before. But I at one point was going towards a path of being a physical therapist. There we go. So I have a degree in biology. And then I started a master’s program. That’s okay. Um, that’s enough for me.
That’s fair. That’s fair. Yes, it’s a lot. It is a lot though. Getting going through all the schooling, is it’s a bachelor’s degree. And they’ve now that they’ve changed the requirements back in 2000, and like six or so or maybe just nine that you, in order to practice you, had to get your doctorate. So it was even more schooling. So that said about seven total years of school.
That’s not fun. That’s like my wife. She’s a doctor of veterinary medicine. So nine years total, one school. How you all do it?
Well, my wife, right. So I actually contemplated shortly after graduating, saying, Hey, should I go get a Ph.D.? degree I have his doctor physical therapy practice. We had a lot of our professors also had their Ph.D. They would do clinical research and super into the research. And she was, I’d like to actually maybe have a house and family one day, especially maybe not be professional students. Okay. All right. That’s fine.
So let’s, let’s start off here. Like, why physical therapy for you?
So a pretty classic story, really, to two things. Pretty classic story. I grew up playing sports, I played three, three varsity sports in high school. And, hoping to play the next level, got hurt in ACL, and meniscus. And then that kind of opened my eyes. I had a fantastic PT that opened my eyes to, oh, hey, this is a pretty cool profession.
I get to work with people, I get to work with people who want to be active and athletic. So So I had a conversation with her about hey, what does it take to get into PT school? And, and then the other thing is, is I always mean before that I always knew I wanted to work with people in some fashion. My father is a physician. My grandfather was a physician as well, both medical doctors and so it’s always going to be to my blood a little bit. So combination of those two, my injury history and the rehab and then just death family history of people who you know, are helping to help people.
So your injury that was at during college during school…
I was attempting to try it out. I was trying to try I was trying to walk on, and that’s when you hurt your knee. And then and then consequently, subsequently, I do it again, playing recreational sports. So I’ve had a couple of pretty major injuries. But, I still am competitive, and like an amateur strongman I still play recreational sports, I can still run I can still lift weights as much as I want to. You know, I did just turn 41 So I got to kind of remind myself that maybe I’m slowing a little bit of that but even with those injuries, I have made myself actually stronger in my opinion.
Working through that gives me a better resolution and up but the main thing it does is I have empathy for anyone who walks in my door and has been there I’ve been at some point where I wasn’t sure if I was going to be able to run again, especially on my second one. It was near 70. But I said I’ve worked through it. Fortunately, use my own knowledge to overcome a lot of stuff and I use I try to use my story to empower anyone that walks into my clinic.
I know for me like in real estate like when I think it was a year year and a half in like the when we bought our first home. So like going through the experience of buying your home, creates like a whole different awareness And as an appreciation for what you’re going through,
Yes, I feel really, we’ve purchased. We’ve had two homes. This is the second home that we’re in right now. And my family, my wife, my family. I remember just 10 years ago going through it for the first time. And numbers, talking to people and, man. It was, it’s a whirlwind. So kudos to you for doing what you do for guiding people through the process for sure.
Sure. I appreciate that. And so for you, it’s like, you’re, like you said, like, you’re able to have empathy for like, what they’re going through, right? And understand the pain, the struggles, and the mindset of it all.
It’s one of those. Not to get too deep, but three minutes in the podcast. But, I was pretty athletic. You know, my little brother would probably say that he’s more athletic than I am. But, I grew up playing sports. And, I was, was pretty good, right? But having this injury, it wasn’t like, I was gonna go pro. Right.
But so having this injury kind of gave me this understanding of maybe what I’m supposed to do here. And when I first happened, especially the second time. I was mid-20s, not really sure what I was going to do with my life. And it kind of set me on the path that I should be on that I am on, and I wouldn’t change, looking back when change anything for the world. Because that led me to be my wife have the family that we have right now have the life that we do, and live in this area, which we love. We love being here. And so it’s it was something that kind of put me on that path. And I’m happy for
That’s what’s cool. So your business, Premiere Physical Therapy & Sports Performance. How long have you guys been open now?
So Premiere Physical Therapy & Sports Performance has actually been around for a while. I think this is a year, maybe? 16? So it was founded on yoga. Before I got there. I started out working for bigger corporate physical therapy. And quickly got a little burned out as a lot of young PTS do. Because we were seeing a scene like three or four people at a time and running around like a chicken with my head cut off. And if people weren’t getting better.
What was your schedule? Like? Then? Like, three, four days? Three, or four people at a time?
For eight to 10 hours a day? So seeing 20 to 25 people a day. And, and people there were a lot of people who were not getting better. And I didn’t know, at the time, I just thought oh, this is how just happens, right? People just don’t get better. Like no, like, there’s a lot more that goes into pain than just the physical. And having a conversation with people goes a long way just basically letting them tell their story. Because a lot of times people just haven’t been heard. And they’re in pain and they just want to kind of vent a little bit and let their story be heard.
You can’t do that from seeing three or four people time. So anyway, long story short, Premiere physical therapy, I kind of looked around a little bit and Premiere physical therapy we shoot we see people one on one every single time, and right there off the bat, this is awesome, right? I didn’t know places like that like that existed. So I left joined the staff and with the intention of purchasing the business from the previous owner he retired moved out of state and so I’ve been the owner now for about five and a half years.
Cool, Congratulations, man. So what do you guys I guess like what’s your approach there? Has it changed much since you have owned it for the last five years have you
Not in terms of how we see people we’re still good we’re still one on one we have my clinical staff just have doctors and a physical therapist nothing against anyone else but I just want I want the same level of experience for each and every patient’s appointment right so that’s our belief is that, having diabetes is going to be a good way to do that. The type of patient may have changed slightly I also have my USA weightlifting certification.
So the Palm Harbor location is inside Palm Harbor strength and conditioning so I work a lot with CrossFitters power lifters because that’s also the type of workouts that I do and so we may have shifted a little bit to see more of that population. People who want to pick up a weight put it down and they’re unable to do so because of pain. But we still see our Medicare patients or older patients we still see your balance patients we still see quote-unquote average Average Joes and Janes who just want to live a healthy life and play with their kids we still see all those as well.
Can you tell where you just focus on— like the strength and conditioning side or like the athlete versus, both?
So if so, for physical therapy, you don’t have to be in pain to come to physical therapy. If you are limited.
Yes, pain is the main reason people come to see us. But if you have a limitation and your strength, a limitation in mobility, and limitation, and balance, those are all things that physical therapy can help improve. So coming back to the performance aspect of it, we can still do it under the guise of physical therapy.
And then why I have options as well, once we move past traditional physical therapy, we do the barbell movements, so I will do more of the performance, the performance aspect as well. It, looks very similar, like if you saw someone on the first visit, and maybe on their 10th visit, it may look very similar. But we have progressed them right. And so I might, you might actually pick up a barbell on day one, it might not be the same amount of weight that you’re doing before. But it’s you’re going to want to try to get you to pick up a barbell if that’s what you’re doing before and this is shouldn’t want to do and then we progress.
Okay. So what is how do you define physical therapy? And then, maybe, from my perspective, I think most people probably think that it’s like, okay, I had an injury, like you’re saying, and then now I need physical therapy to get back to my state that I was in before my physical state that was in before.
Right, that’s definitely the traditional definition. And that essentially encompasses the majority of what physical therapy is. But physical therapy, especially in this day and age, especially with COVID, what’s been going on, and people getting a better understanding of, oh, hey, like, my fitness actually does matter.
First things like this physical therapy is also preventative. So you can be something where anyone can come in for an evaluation for physical therapy. And on that evaluation, it’s our job to determine Do you have strength deficits? Do you have mobility deficits, not just for pain?
Do you have all these things that may lead you to have an injury down the line, and then we can prevent it ahead of time? And insurance will very well at least cover that very first visit? So I work with insurance and out-of-pocket payment, as well. But so the point is, if you’re basically if you’re curious about your health, a Doctor of Physical Therapy can do an evaluation, and determine if you are appropriate to come to physical therapy.
Cool. So what does that evaluation look like?
So it’s a combination of it’s, it’s a combination of what you may encounter if you go to an orthopedic medical doctor. So we do an orthopedic exam. So as doctors of physical therapy, our education is to be able to diagnose and treat musculoskeletal disorders. So doing clinical tests, like to determine if somebody’s got a rotator cuff tear, or ACL tear, or just a little fashioned ankle sprain, we do that examination. So I do a hands-on test for that. And then the main thing that we do is we watch how you move.
So yes, you may have had an ankle sprain, but I’m going to see, all right, I want to check what your balance looks like, I’m gonna see how you walk, I’m going to see how you squat if you’re able to do a single leg version of a squat, and so that all and then combined with my hands on assessment, meaning I’m going to look at are you lacking mobility, does your joints stiff? Do you have a restriction and your soft tissue, and that all kind of all that stuff together combines a picture of Alright, here, here’s a quote-unquote, medical diagnosis.
But really, we’re treating these physical impairments. And so physical therapy will then once we get that diagnosis, say, Hey, you have limited mobility, we’ll do some hands-on techniques, we’ll do teach you some exercises to improve your mobility, and then improve your balance, improve your strength, so on and so forth.
You kind of touched on this before, but the preventative side of medicine and just people being more aware now of their health and, and everything that really affects like your overall health. Have you seen a change in that and like more people coming in for preventative measures?
Yes, definitely. Especially as they’ve been like, since COVID. Or before that. It was.
So there was a there was definitely a shift that was beginning probably, are we, when I first came out, so I’ve been practicing since 2012. So there was starting to be a shift. Okay. I might have also, it kind of biased my patient population. What I do, right, but definitely since COVID. People who are just starting to get neck pain and back pain from sitting all day long.
We know, we know there wasn’t a big serious injury, but they know their job is going to require them to continue to sit for a prolonged period of time. And so they So like they would come in, and a lot of times the story was, Hey, man, it’s not that bad. But I know I’m gonna be doing a lot more sitting and sitting is hurting me is causing me pain. Can we do something about it ahead of time? So there was shift the shift is, it has been a significant increase in the last like three years now.
Crazy. Which is, but overall, it’s good, right? Like, no more being more aware and conscious.
I mean, it stinks. It takes, a pandemic, for people to get a better understanding of why their fitness is so important. But, at least people were getting a better understanding.
So let’s dive into that a bit more, as you mentioned before, about, like, minimum exercise guidelines, right? And like the majority of the population is not reaching those, right? So like, what are those guidelines, and let’s talk about that?
So the minimum guideline is from the World Health Organization. And it was updated recently, I think, maybe two years ago. And the whole point of these guidelines is, these are the minimum requirements to help you. It’s not going to guarantee but it helps kind of stave off systemic conditions, diabetes, high blood pressure, upper respiratory infections, things along those lines, cancer potentially even.
And so those guidelines are on a weekly basis, you need to average at least 150 minutes of moderate intensity, cardiovascular exercise, and two days of moderate intensity, resistance strength training. So moderate intensity, there are reasons a little subjective, your moderate intensity might be different than mine might be different than someone who’s, 70 or 80 years old. And that the whole point is we want you to want people to kind of start to push themselves a little bit moderately.
So what exactly does that mean? A moderate, if you were to take like a rate of difficulty on an exercise of a workout itself, the whole workout 10 out of 10 means I was very close to going to the hospital,, on the floor?
And like the type of thing. I couldn’t do anything more, you probably want to keep that workout around like a six to seven, eight, maybe. Right? So essentially, if every workout, it’s like a moderate level, it’s like a water level. Right?
So if art, can you do a workout? That’s a two or three short, right? But then you want to make sure that, hey, all right, I may need to do a little more. And that seven range. And so it doesn’t have to be, again, 150 minutes, it’s not like, I got to do 150 minutes in one day, over the course of the week, right? So maybe one day is 30 minutes of gentle walking, but maybe one day is 30 minutes of I’m gonna get on the rowing machine.
And I’m going to try to kind of push myself a little bit to get my heart rate going. So, here’s my standard caveat. Or disclaimer, that should, before you just anyone just hops into this, like, get yourself checks. If you haven’t got a check, make sure that your heart is healthy, and so on, and so forth. But those guidelines are there, they’re in place because they’ve done studies and people who hit those guidelines have a significantly less chance of succumbing to those systemic conditions.
Is that just a problem in the United States? Or is that a problem just like across the world, just like people in general?
So it is across the world more so in the United States. So the statistic is that, even though this as is the World Health Organization, the statistic that we have, since we’re here in the United States is that 77% of Americans are not hitting those guidelines.
And my job is I don’t want the pain to be a barrier to you being able to exercise. So if I can help reduce your pain, or you can exercise and you can hit those you can hit those numbers. We’ve all won
What do you think? Why do you think that is like why do you think it’s like 77% Like don’t walk or have some sort of moderate exercise?
Obviously, there’s not one magic bullet but if you look at how much time we have look at American society right, we’re a society where everyone loves driving, we have highways, we have a highway system, right everyone likes everyone commutes a lot of people commute to work with the exception of the big cities. You know, in Florida like commute, I have a 30-minute commute to my clinic.
And so do you compare that to European countries where there’s a lot of walking?
Anyone can walk, to their job? You know, like Amsterdam? Everybody’s on a pike. Right. And so the people are getting that exercise in, well, really chewy quote, unquote, exercise. Sure. So I think that’s a big thing. I’m not, I’m not here. I’m not anti-patriotic, I love America. But it’s just, it’s the way they kind of our society is built. And I think that is a big, no pun intended. That’s a big step in, in why we are that why that number is so much higher in our country.
So it just takes more of an effort more like to be aware of what I need to get this exercise in, instead of just like, I’m getting it into my daily, correct? We know life.
It’s not that Europeans exercise more than we, purposefully, right? They just, it’s built into their lifestyles differently.
That makes sense. So what are some, what are some, some tips are for people who are like in that 77% and be like, okay, like, this is inspiring me, like, I need to get up and get moving, like, how do we get started, right?
The easiest way is to find something that you like to do. And then that just allows you to move. And so it may be something as simple as just starting to go for a walk. Right? And it might even be that you can only walk for 10 or 15 minutes. 1015 minutes is a heck of a lot better than zero, right? And so maybe start something there.
Maybe you had too much pain even do that maybe getting if you have access to a pool, and just getting into a pool and walking in a pool, right? Just simple things like, you can just get up, stand up and sit down in a chair. And just that’s, that’s one of the simplest exercises that people do is, hey, you have a chair, you sit in it, how about you stand up? And you sit down? And do that a few times throughout the day?
And so it’s a combination of finding things that people are already doing. But that they also like to do as well, because I know that I’m, I’m different, right? I’ve I wake up between five and 530 every morning, and I get my exercise and I get my workout my lifts and and I know that I am in the minority when it comes to that because it’s I love it.
And they’re not in the people who come to my clinic who are like that, sure. I know, that I wouldn’t need to do for them is find something that they are already doing that they enjoy doing. And that’s us. That’s it. That’s our first step in the process.
And then, as you said, keep it as simple as possible. Right?
And so once you kind of get going, and you you’re able to kind of establish a little bit of a pattern, then we can start to say, Alright, hey, you’re doing a fantastic job. You’ve, you’ve been on a 10-minute walk every day for the last three weeks? How about, we see if we can do a little bit of some strengthening exercises, right? I’m assuming T is a little bit of that in, maybe we try to gradually increase the walking that you’re doing.
So it’s, it’s not going to happen overnight, people aren’t just going to, hop from zero to 150 minutes, in one week, it’s going to be a gradual process. So it’s, and that’s what kind of where we come in, to help guide people through that I, it’s kind of new cliche, but we kind of view ourselves as like, people’s Yoda. Right?
Where you’re, where your guides, through the process. So to give you an understanding of, is a pain you’re experiencing, okay? Something that we need to actually do something about? Is it a call appropriate or inappropriate? And then it’s telling you like, Alright, here’s, here’s what to expect over the next 24 or 48 hours. Here are other things that we want you to do here is your roadmap to getting you back to doing what you want to do or receiving those numbers.
I think it’s important to have, someone like yourself, like in your corner, right? Because you get like the pain level or experiencing pain, like if you’re exercising and you’re doing things at a moderate level, or pushing limits a little bit, you’re at some point, you’re probably going to experience some sort of pain, right?
So understanding, it’s as good pain is as bad pain, like, this is okay to push the limits on this. And that’s, like I go back to, like running, and every time I I’ve gone through where I trained for a half marathon, and then I back off and stop training for a while and then see something new. I’m starting over basically. So every time I start over, like, there’s I experience pain and ankle and your knee and all that kind of stuff. Right?
Then eventually your body adjusts. Right, right. So you have more of a little more experience or US you’ve been there before you Oh, okay. I remember this, right? And so a lot of it. A lot of our pain comes back to how we were brought up as children if did you have Parents who, every time you fell over and skinned your knee, did they coddle you and make sure that oh, you okay? Or did you have parents? Kind of like mine who were like, Are you bleeding? Are you dead? You’re right.
So going into Now that leads into, alright, well, now today as an adult, I’m going to start a running program. And you may have never had an injury before in your life. And then you start to experience some discomfort because you’re starting to run. And you’re kind of freaking out, you’re like, I don’t know what this is.
So then you might have secretively shut it down. And so then that’s, that is where we come in to say, Hey, listen, let’s talk about the pain and our understanding of descriptors of pain. The timeline of pain, the time that it takes you to recover from pain, what makes it better, what makes it worse, that’s, that’s where we can come in to be your guide and say, like, Alright, look, let’s pump the brakes. We don’t have to stop running maybe you run a little bit less.
And we take a little more gradual approach, or, Hey, maybe you actually are limited and your strength, do some strengthening while we gradually work on the running. And just that’s kind of just an example of what it kind of looks like in a nutshell.
Which is such a valuable resource to have to be able to have someone to go to like that.
I wish. I wish that some part of the reason that I injured myself was that I was not doing enough of agility drills that I should have been doing. And it’s a cliche, they say, Well, I wish I had somebody like me when I was younger. Yeah, I might have been on a different path. But I mean, it’s and that’s really all we try to do. I’m just trying, yes, I have degrees, but I really just trying to empower people to get to move.
I love that. And it’s so simple.
It can be so simple.
So I want to talk a little bit about like, the business side. And, like, what was that experience? Like, for you? Like, getting into the business I know for you is probably a little bit different than just starting your own business, right? Because that was established before, but kind of like that transition for you. How was that? And what did you like about it? What did you do?
It was a big, big leap of faith. And I give credit to my wife and my parents, they’re my family was a big support system that had to give me the confidence that hey, you can’t do this. And we briefly toyed with the idea of opening my own business and starting from scratch. At the time, I had a six-month-old. And so my wife was just kind of reentering the workforce a little bit. So it would have been tough. And so, um, so we found this, we found Premier and the, the former owner, his name was Eric Schweitzer. He’s very gracious and basically takes me under his wing. And so for a year, he said, Hey, listen, I want to I’ll show you what I’ve done to be successful. Because by that point, his business had been around for almost a decade.
So you’re obviously doing something. And, so he said, you can take what you learn here, and then hopefully, that allows you to take premier to the next height to next step. And so I kind of got a crash course. And I know, I know that I’m, it’s a different experience. than most people in terms of starting from, from from groundwater from from ground zero, but it still was a crash course. And I still am, I’m still my mistakes are becoming fewer for further between.
Honestly, one of my biggest accomplishments was not having to close the business down, when COVID hit, we are we’re a smaller, kind of more boutique practice. I have two other deputies. That worked for me as an office manager. And occasionally, we have some part-time front office help. And so we’re not a very big firm for either practice and not being able to keep everyone on my staff. And not closing the business down was honestly my biggest accomplishment so far as a business owner.
That’s pretty cool. I mean, which is, which is a huge accomplishment during like, this pandemic, where nobody knows what to expect next, and that sort of stuff. So stick through that when so many other businesses closed down. It’s pretty cool. So what about the future of your business? Like where do you see that going? Like, what do you want to accomplish there?
Well, we are hiring. So if there are any doctors in physical therapy, listen to this podcast with hey, send me your resume. I so with the Palm Harbor location is, I can’t quite call it new anymore, I guess is new-ish. It’s been around for about 14 months in the inside Palm Harbor strength and conditioning. Okay. And basically, what I’m trying to do is essentially scale that out. Um, because I feel like it is a way to scale the business where I, it’s kind of a, I’m a solo practitioner in that in that one, my Clearwater location is more of a traditional PT setup, okay, but I basically have my treatment room inside the gym, and then I have access to the gym. And so I’ll do my evaluations, my hands-on treatment, some exercise inside the treatment room, and then we get people out onto the gym floor and start working there.
And, hopefully, I can bring someone else on my staff, but it will be a dream of mine to essentially get a little bit of kind of like premier physical therapy, satellite practices within other like-minded facilities in the area. So that’s long, long-term type plans right now, I’m still seeing patients, still managing the business still, trying to make my employees happy and, and doing all those things as a business owner, which I love. It’s a great challenge, in addition to working with patients, but that’s those are, those are the plans. I love, love, and make it happen.
That’s pretty cool. I’d love to hear that. So when you’re not working with patients and working on the business, what do you like to do in your spare time?
My, wife, listen to this show, hopefully, laugh. I was having a conversation with a buddy of mine the other day, there basically are four things in my life that take my top priority in some order. My family, wife, my children, they’re out there, right?
So I go home and like, my kids are younger. My daughter is almost seven, my son just turned three. So it’s a great age. And so I am trying to do as much family time as I can. Other than that, it’s lifting weights. And I play a lot of golf, too. Oh, no, that’s you don’t have to go to the oh, look like your hand in hand.
But I’m a big golfer I’ve played since I was 10. That was one of my varsity sports. I was. Oh, cool. So, I love playing golf and trying to do some golf trips. So that’s pretty much it, then the business is in there. Isn’t there someone? So those are I mean, I’m relatively simple, man. I like to, come home and enjoy time with the kids and maybe have a nice little bourbon and, and just enjoy. Enjoy looking at my back patio. And thinking when’s my next tee time?
So, what’s your favorite course? Around here?
Um, around here, man. I’m a big fan of? Well, obviously, around here. Lake Jovita is one of my favorites.
So I don’t know. I don’t know what the definition of around here is. We’ll go with that. I’ll go with that one. But we’re specifically looking at the Palm Harbor area.
I’m actually I actually do have tee times today. Does Cypress Run? So I have a buddy of mine who can get me out of that school. So a Cypress Run is definitely one of my favorites. We live in the Eagles, which is a cool dance. So that’s it. And so that’s, that’s also, of course, that’s because I can just walk right on. So is that so I’ve played that course? And like, it’s, they have the forest and the lakes, right?
Yep. Like, I know, they’ve struggled with the condition of the course like, how is it now? Like, what’s it’s getting better, it’s getting better. So they’ve been going through, I don’t want to be too honest, we got to turn too much. This is my knowledge that they will go through some managerial changes. And so they have, their focus has been on trying to really improve the clubhouse situation, which I think is improving better. The condition of the courses has definitely improved in the last nine months or so.
They get a lot of play because they have reasonable rates. And so I don’t expect too much. But it’s the course design is fantastic. In my opinion. And then the crew out there, they’re doing a good job. And it’s coming around.
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