Combining the LTAP™, Shockwave, & Laser For Better Results - LTAP™ Alumni Interview
In this episode of the Unreal Results podcast, I sit down with athletic trainer and LTAP™ alum, Maria DelliVeneri, to explore what it looks like to run a private practice that blends regenerative medicine, shockwave and laser therapy, and whole-body assessment.
Maria shares her journey from working in high school and collegiate athletics to serving an older, but still very active, population in Bend, Oregon, and how she’s using LTAP™ to get breakthrough results with some of the most complex cases. We dive into how she integrates neuro-visceral assessment with modalities like shockwave, what it really takes to help clients who have “tried everything,” and why meeting patients through a lens they already understand can make treatment stick.
Maria shares powerful case examples, from helping clients avoid unnecessary exploratory surgery to restoring lost range of motion after knee replacement.
If you’re a clinician looking for new ways to approach chronic pain, stubborn movement limitations, or combining advanced modalities with whole-body assessment, this episode will expand your lens and show you what’s possible when you treat the whole system.
Resources Mentioned In This Episode
FREE online mini-course, The Missing Link, is now open for enrollment! Sign up HERE!
Connect with Maria on Instagram
Maria's Clinic's Website
Learn the LTAP™ In-Person in one of my upcoming courses
Considering the viscera as a source of musculoskeletal pain and dysfunction is a great way to ensure a more true whole body approach to care, however it can be a bit overwhelming on where to start, which is exactly why I created the Visceral Referral Cheat Sheet. This FREE download will help you to learn the most common visceral referral patterns affecting the musculoskeletal system. Download it at www.unrealresultspod.com
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Anna Hartman: Hey there and welcome. I'm Anna Hartman and this is Unreal Results, a podcast where I help you get better outcomes and gain the confidence that you can help anyone, even the most complex cases. Join me as I teach about the influence of the visceral organs in the nervous system on movement, pain and injuries, all while shifting the paradigm of what whole body assessment and treatment really looks like.
I'm glad you're here. Let's dive in.
Hello. Hello. Welcome back to another episode of the Unreal Results Podcast. I have a special episode today. I have one of my friends and colleagues and alumni from the LTAP level one courses with us. Um, Maria, she's up in Bend, Oregon area, and um, she learned from me, I think last. Year, a year ago. Mm-hmm.
Hmm. Yeah. A year ago. And, um, has been utilizing the LTAP in her practice and, um, I wanted to bring her on the podcast today and have her share about how she uses it and then also just share about her pro practice. 'cause it's a very unique, um. Practice setting that she operates in, especially for athletic trainers.
And I'm all about letting people know all the options that athletic trainers have to like make an impact in the industry. So, um, yeah, I'm excited to have her. Without further ado, welcome Maria. Thanks for joining us.
Maria DelliVeneri: Hey Anna, thanks for the invite. Great to be here. So, as you said, I'm Maria DelliVeneri, certified athletic trainer since 2008. I've been working in every setting that athletic trainers could possibly be in from high school to college to power five. But since 2014, I switched over to the clinic side, and then most recently in gosh, 2022, my own private practice up here in Bend, Oregon.
Anna Hartman: I love that. Um, and with your, um, private practice, what kind of, what, what kind of patients are you seeing most of the time?
Maria DelliVeneri: Yeah, great question. So as an athletic trainer, I think that's one of the biggest things I hear from colleagues of like, I wanna work with athletes. Like, I don't wanna give up working with athletes so much. And quite honestly, that was one of my hesitations too, when I switched over to be like, what's it gonna be like working with general population?
Well, if you've been to Bend or heard anything about Bend, you'll realize that like these folks are athletes. Throughout their entire lifetime. So while my general population does average kind of 55 to 75, these are still the folks that are, you know, playing pickleball four days a week. They're skiing 70 days a year.
There's riding their bikes, they're hiking mountains. So it's not your average patient population. Um, so with that too, with the folks that have that mentality of go, go, go, you still get that excitement of like working with the recreational athlete except now, rather than being at that high level of college where you're taking people that are already from here to here, you're taking people that are still, you know, they're here and they're active, but now they have things like.
You know, they're 40 years older than our college athletes. They've lived life, they're retired and wanna keep going, but they still have that mentality of they don't wanna stop. So it's, it's hard. I always say to them that I wanna be them when I'm retired. It's really cool.
Anna Hartman: I am like, retiring. Invent does not sound like a bad move.
Maria DelliVeneri: It's not, it's not. So,
Anna Hartman: and mountain biking and hiking and all the things, so.
Maria DelliVeneri: Right.
Anna Hartman: Um, I love that. So when you, um. When you originally found me, however you found me, I don't even know how you found me. Um, what made you feel like the LTAP was the, well, was the thing that you needed, like what was the problem that you were having in your practice or like what were you hoping to gain from taking the courses?
Maria DelliVeneri: Yeah, great question. So I actually found you way back when on some Fit Cast podcast episode Oh yeah. With Kevin Larabee. Yeah. And you were doing all your work with Mike Boyle and stuff? Yeah. Um, way, way back when. Wow. Yeah, Kevin,
Anna Hartman: I haven't talked to him in ages.
Maria DelliVeneri: Mm-hmm. So that, that podcast man, that got me through, through a job one time when I was working for the state.
Needless to say, a lot of foundation to get me where I am. So how I found you, gosh, I was searching for a problem or the searching for a solution. The problem that I had with my work since 2014, I've been specializing in using shockwave therapy and Class four Laser for regenerative medicine purposes and focusing with the older adult.
So. In the United States, shockwave is still kind of in its infancy here and starting at, I wouldn't call it a household name yet, people are still learning about it. So typically when people finally stumble upon shockwave, it's 'cause they've tried everything else. So they've tried rounds and rounds of pt, chiro, acupuncture, they've been doctors.
Maybe they finally went down the surgical route. But their pain's still there. So that's when they usually would come into my door is something where, you know, it's not like I rolled my ankle on Friday and I'm seeing the athletic trainer on Monday. It's kinda like I injured this thing. Six years ago tried everything and I'm still dealing with it.
So that right there is a complex patient, um, that tends to, as you know, just has so many layers that's with it. So with shockwave and laser, what it can do for the body and what it can do for that internal environment of where the actual pathology is, is really pretty remarkable. But at that time, typically with people with chronic injuries that are walking into the door have all sorts of compensations and layers and things that come with it.
Mm-hmm. So what I was trying to, or what I was really struggling with is really getting to that point where like. They're getting better, but either not all the way there or there people that are not responding even to shockwaves. So like, you know, as a clinician, like you get that patient where you're like, they're banking on you to be like, you are the thing that's gonna be there.
And then you get the whole other layer of like, oh, it's another thing that didn't help me. So. That just motivated me to be like, well, that's not gonna be me, or I'm gonna try to, like, how can you minimize that? Yeah. And so what I started picking up as I was seeing more people and people and people that I was treating is like you pick up on the patterns that people present with and compensate with.
Mm-hmm. And that actually led me down the PRI rabbit hole. So I was deep in that for, gosh, maybe about, probably four of their courses I've taken and some of their secondary ones. Um mm-hmm. What I was finding at my last job, like at Canyon Ranch, people come for either you see 'em once, they might be there for a week or they live there for a lifetime.
So very small time amount that you could have to like change and make an impact on somebody. So with PRI. It can, it's, it can be cumbersome. I was novice enough that I could stumble through some stuff, but like I couldn't really nail it home with people with that. And so I was searching for something that like was still a neurological focus.
'cause I could see like, that is where you can really start making changes for people. But I knew that I needed something better and faster or different or more precise. Mm-hmm. And so when I started hearing your stuff online, I'm like. This seems like a set. Yeah. It's like coming from, you know, we speak the same language as athletic trainers.
We know the background of that. We know how to look at bodies that way, but it's like finding that extra layer of going through something that's a set assessment focused and quick to make an impact on people combined with shockwave and laser that can do its own thing was huge.
Anna Hartman: Yeah.
Maria DelliVeneri: So it's like really, I guess finding a way of like.
With complex patients or the older gen pop that's really, really active. Um, it's usually not just straightforward as what we'll see with an acute ankle spraining patient. So it's like, how do you find those layers? And that's really where the LTAP started drawing my attention. Mm-hmm. And really sought me into the, the ecosystem with it.
Anna Hartman: Yeah. It's, you know, as you're talking, it's interesting too because it's like, um, the. Well, a couple things come up. Uh, number one with the PRI stuff, you know, I've got, I've gotten a handful of people come through the lt a, um, course, the level one course that have come from A PRI background and, um. It's been cool to see how people like, I mean, overarching, no matter what background people come through to the LTAP after they l learn it, they're like, oh, it's so nice to now know where to start with all my tools.
Mm-hmm. You know, which is like, what I love about it is like you don't have to throw out everything you know, and everything that already works in order to like utilize it. It just slides right in and compliments everything. Supercharges it in a sense, but it's one of those things too. And you know, and this is, I think what you were seeing as be between the shockwave and being able to treat the nervous system and like the physiology a little bit more with that.
And then also with the PRI, you know, at the end of the day, even though people think of PRI being, um, a lot of hamstring exercises and core stuff and breathing, like when you look at. When you look at the body from a whole organism standpoint and you start to see, start to consider the viscera in the nervous system mm-hmm.
You start to see that the breathing exercises, though they breathing is an important part of our stability system. Um, it really is something that's really influencing our viscera and our nervous system. And so when you look at, um, and exercise. Well, and I will say this too, like, you know, I know PRI goes even further down the rabbit hole of the viscera and the nervous system.
Mm-hmm. And neurological stuff, and central nervous system in more, they're more advanced courses. So I'd also say like pigeonholing them into what most people know them as, which is like mm-hmm. Core exercises and hamstring exercises and breathing exercises is like probably unfair to Ron and all the stuff that he's created.
However, that is at the end of the day. Still what the majority of people think it is. And I'd say the majority of people utilize it that way because they don't go through the advanced courses. Right. And so, um, but it's cool because it is a modality that gets. Good results for people, especially for people who, you know, failed at traditional rehabs a lot, like there's a mm-hmm.
Doesn't, at the end of the day, like there's a reason PRI got really popular is because people got results with it. And so it's like something's not gonna get popular like that unless you are getting results. And so then for me, I always think about things like that no matter what exercise. I always tell this story in the, when I'm teaching in the LTAP level one about.
Like pelvic clock exercises that I used to do with my patients. I, I started noticing the patterns, like you were saying, the patterns in people. It's like no matter what issue they had, whether it was back pain or hip pain or knee pain, sometimes pelvic clocks just seemed to be like one of the most powerful exercises for everyone.
Mm-hmm. And across the board, people really liked it and. It, it was, I always remember thinking like, what is, what is, what is it about the pelvic clocks that, um, seem to universally be such a good exercise? And, you know, you can, when you know anatomy enough and you understand sort of like the biomechanics and the like core lumbopelvic control stuff, you can like bullshit your way of saying like, why you think the pelvic clocks are working.
But when I started learning visceral anatomy and when I started learning about. The nervous system and autonomic nervous system a little bit deeper. The central nervous system, a little bit, bit deeper. There was this light bulb that went off and I was like, ah, now I see why the pelvic clock exercises were so powerful is because I was treating the viscera.
Maria DelliVeneri: Mm-hmm. I was
Anna Hartman: treating the autonomic nervous system. I was treating the central nervous system. So it was a really high payoff exercise in that standpoint. And when we look at, um. You know, and so breathing exercises end up being like that too. It's like, yeah, they're creating stability, improving diaphragm mechanics, but when you like the diaphragm at the end of the day is the main muscle that's splinting the visceral organs when the visceral organs are not moving well.
Mm-hmm. And so it's like, but on the flip side, doing breathing exercises or doing mobility work around the rib cage, focused on diaphragm mobility, diaphragm function, you are inherently. Then going to mobilize the organs. And so you're getting this added layer of doing visceral work. And you know, and this is a big thing too that I, I, I think I really advocate for and.
Teaching this work is, as much as I've loved going to the Barral Institute courses and I refer, I recommend them to every clinician. Like at the end of the day, we've always been treating the viscera and the nervous system. We just haven't been seeing it through that lens of view. And when you can start seeing it through that lens of view, now you get to pick and choose the exercises in a different way.
Like because of a different reason, and they become even more powerful. So, you know, I love that you started. To like question that and like realize that too. And so it's like, yeah, this like it is fitting in perfect for you. Mm-hmm. Your love so
Maria DelliVeneri: huge on that day-to-day part of it. And I think the bigger thing you bring up too is um, talking about the different lens to go through.
Because the biggest thing that I think I've really started incorporating most recently is conversations with patients of like introducing them to that lens because like. As human beings, we don't really have a great understanding of like, what is pain? And like anything I have pain must be a musculoskeletal thing and it must be something I can touch and feel because that's all I know I can conceptualize.
Um, so when you can start connecting dots for patients, I think that is huge, um, for those experiences and they can start feeling it in themselves. Mm-hmm. And seeing where that comes from because. Oftentimes I find that they don't necessarily have like the words to fully vocalize or fully tell the story of what they're seeing, feeling, or how they're moving just because they don't have another lens to come through with it.
And so sometimes too on the flip side, knowing your patient, meeting them where they're at with that part of it like. They may not have the full capabilities to sit with you and be like, oh, here's truly what a central nervous system is and what it is, and here's the viscera. But if you can come at 'em with a breathing exercise and they're like, oh, I know breathing, I know core stability.
And so it's like you're, you're giving them what they need packaged, uh, what they know and then kind of meet them along that journey to, to get that outcome. So that's been really helpful too, to pick up like different ways. Like you said, like choosing, um, an exercise that has so much more power to it to have an impact and like really knowing it's a way there that they're like, oh yeah, it's a pelvic clock.
I did this in Pilates or saw this somewhere. Um, and you're like, oh yeah, perfect. You're familiar. So they feel confident with it too, 'cause it's not something totally radical, which again, like PRI concepts are really interwoven into a lot of this, but for a lot of people, like. They really gotta be on board with you and they really gotta have full trust and they really gotta like have the patience and the concentration and the dedication to execute it.
Whereas like if you give them a pelvic clock and they have the same outcome, 'cause you influence their nervous system and their viscera and their movement. Like huge.
Anna Hartman: Yeah.
Maria DelliVeneri: Huge, huge.
Anna Hartman: I love that. That's a really good point. I haven't thought about that, but I do see that and I do think that that is like. I always tell people, you know, when they ask about my athletes and my clientele and they're like, oh, you must, you know, like, oh, if you go to someone's team, you must see so many of the team.
And I'm like, well, no, that's a very specific client that is like open to this kind of thing. But I, and I, and I think about how other like visceral and neural practitioners are and the, the, the, the treatments they do and like the setting they're in and I'm like. Yeah. Some of my athletes just would not be okay with that.
Maria DelliVeneri: Mm-hmm. And it's
Anna Hartman: like, yes, a lot of the times when I'm like cupping or doing and having them do an exercise or whatever I'm having them do, they just see it as a musculoskeletal exercise. But I am giving it to them for like a very deeper, literally, literally deeper reason of targeting the, the nervous system or targeting the um, visceral organs.
You know, so it's just, it is. I love that you said that because I'm like, yeah, I didn't even really think about that as utilizing this lens of view with old exercises that people are familiar with. It's already predictable to their brain. It helps 'em feel safe. It truly is a way of meeting them where they're at.
Um, which is just, I mean, that is one of the core beliefs, like principles, the osteopathic principles that we operate mm-hmm. Inside the LTAP and with the treatment is like. Meeting the body where it's at is so important and not forcing it. Right. And so I love it. Like you nailed it. Like that is, it is so nice to be able to like speak, even though we know we're not operating that sole musculoskeletal, biomechanical lens anymore.
Mm-hmm. Not that model anymore. Like we can still. Package it in that model so it makes sense to the athlete. It makes sense to the person because, yeah. At the end of the day, the more famous part of the body when somebody's coming for rehab or body work is they think everything is their muscles in their joints.
Mm-hmm. That's fair. Like mm-hmm. It's fair too, because it's like that's how we're re, we're designed, the musculoskeletal system is the bodyguard to the most important things. And so yeah, our pain is gonna man manifest, man mus in our musculoskeletal system because that's its job. Mm-hmm. And so it's like, yeah.
Why would, what purpose would it serve of telling the person, like I get it, explaining them to understand where pain comes from in the brain is valuable for them to understand why sometimes. Pain can be challenging and get rid of, but also like, they're like, well, okay, but my shoulder still hurts. Yep. A thousand percent I get from my brain.
Yeah. I get, it's from my brain, but my shoulder like this, this hurts and it hurts
Maria DelliVeneri: now.
Anna Hartman: Yeah. So I'm like, it's almost like forcing, like you're, it's a, yeah. You're forcing them to try to understand it from a scientific level. And they're not scientists and they're not. They don't care. They just don't want it to hurt anymore.
And so it's like, no, your job's actually to get them to not hurt anymore. Mm-hmm. Maybe educating them on it will be helpful. And is it a part of it? But a lot of the times there's a lot of other tools that you can use.
Maria DelliVeneri: Oh, for sure. Yeah. Um, because I think, I mean, that's just like one of the biggest struggles that we have, right in orthopedics is just.
This concept around pain, like pain's not fun, and it's not a great experience. Like, and so when you're trying to tell a patient like, oh, it's necessary, your body's doing its job, that means that your body's doing something great. It's still back to that part of like, yeah, but it sucks to live in this body that hurts.
It's literally
Anna Hartman: like gaslighting people.
Maria DelliVeneri: Mm-hmm. Yeah. Yeah.
Anna Hartman: I'm like, what? Why would we do that? Oh
Maria DelliVeneri: my gosh. Yeah, yeah, yeah. Which is like a whole other bigger conversation, right? Yeah. But, but, and I think that's, that's just the reality of that aspect of it. So like, especially. Again, when I get those complex patients that again, have tried everything, but they still have pain, like you're dealing with a lot of stuff.
So not only like the physical presentation of these humans, um, but also looking at like those thoughts and beliefs and experiences that they've had. You know, so that's really where it is important. If you can have something that can be. Effective and it's fast because again, like shockwave and laser, we're remodeling and regenerating tissue in an internal environment.
So like we're still playing the long play here. Yeah. Um, like, don't get me wrong, like we can get some acute hyper analgesia. We can get something where sometimes people will feel better pretty quick, but like we're still waiting kind of, you know, six to eight weeks post the last treatment to really get the ball moving on that tissue from ant interim environment.
So like, yeah. How I really share with people is that like, yes, um, these modalities can have a time and a place to truly improve that environment, and we're doing that, but like in the meantime, let's work on you as the human and like just optimize every bit of that movement. And so like having that lens, um.
And coming from the LTAP, like it's, it's radically changed every bit of my approach to patients and patient care. 'cause like now I have another way that's like fast it's effective and it like, puts a name in my head to what I've been seeing for a long period of time. Mm-hmm. And having to work for it. Um, 'cause like similar I imagine
Anna Hartman: too.
Sorry, I, I could imagine too, you know, knowing that. Shockwaves a little bit of the long game when you are trying to remodel the tissues and, and, and, and change the physiology. Um. I can imagine that when you have a tool like the LTAP and can concurrently take away their pain very fast and change their mobility or like their strength very quickly.
Mm-hmm. Then there's more buy-in to continue to return for that shock wave over the next six to eight weeks or whatever it may be.
Maria DelliVeneri: Mm-hmm.
Anna Hartman: As opposed to like if you just were using shockwave like. And you, you know, don't get lucky and get a pain decrease the first couple sessions they're like, I don't know.
I don't really feel a difference. Because you might not until the tissue can change.
Maria DelliVeneri: Yep. Oh, huge, huge. I actually had that conversation with a patient today because, um, having like. Torn meniscus on top of arthritis in her knee and kind of having this expectation of, you know, she had PRP three weeks ago and she was like, I don't think I'm getting better.
I don't think it worked. I don't think all this stuff. It's because, again, like not only as humans do we not really know about pain, but we also don't know like a healing physiological timeline and like what do we, what, what's actually possible within the body and like what can we truly like speed up and support versus like what is truly going to take mm-hmm.
Time. Mm-hmm. Um. And so I think that's a big thing too. Like we just as humans, like we don't know that. We just think that like, well, I'm not injured anymore and I'm off crutches, so I should automatically be better. Or It's been three months since surgery, I should be cured. Right? And so having that ability to, to.
One, kind of like set realistic expectations, but then two, help anything that's an underlying, something that their body has been presenting with. Huge, huge, huge for that.
Anna Hartman: I think that it, you know, and that brings up a whole nother can of worms of like, so often, you know, they go. In those instances, they go to doctors and the doctor's like, oh, you have pain because of this, so we're gonna do a PRP injection and it'll take your pain away.
Mm-hmm. And it's like, if it doesn't, the person's like, I don't understand. And it's so, it's also like sometimes I feel like, well, like any tool, like any, like anything. Mm-hmm. Sometimes when the doctor decides the treatment plan, it's not the actual thing that was the driver of the pain anyways. Yeah. And then too, like you were saying, when you can't.
Is the PRP injection or is the shockwave like changing tissues? Probably. But when you can't see it. Mm-hmm. And it takes so long to feel it potentially. And then the feeling of it is not even that reliable of a. Thing.
Maria DelliVeneri: Yeah. '
Anna Hartman: cause then we're getting back into the pain category as like Yeah. It, I get why it's hard to believe mm-hmm.
That it's doing anything and so frustrating. Um, which always goes back to like, going back to like why it's so great to have a tool that can help with the pain and help with the actual, like, functional limitations that are bothering the person versus the, the tissue problem.
Maria DelliVeneri: Mm-hmm. Oh, a thousand percent.
I had, um, one patient. Gosh, he was suffering for, maybe it had to be a year by then of pain down in his foot, like excruciating pain, like swelling just out of the blue and like couldn't explain what happened. Just has been there. Didn't go away for a year. Went down the route. Pt, um, did all the things he's supposed to do.
He went and had an MRI. MRI showed like possible like inflammation of, uh, posterior tip. So, okay. Diagnosis, posterior tib tendinitis. Cortisone injection, no change. And they're like, okay, next step is like exploratory surgery. 'cause we don't know what's going on. Oh yeah. Wild. Wild. This is like a 30 5-year-old guy who's active.
Works out in the field. Yeah, so Exactly. So it was so cool though, 'cause like when you are looking at it and looking at the posterior tip, doing all the testing for posterior tip and you're like, oh, it's not really looking like a duck or quacking like a duck. Like what else can we see that's going on here?
Like. Just because it shows something on M mri, right? Like mm-hmm. Doesn't have to be the driver. Um, and so we went through the LTAP and it was, it was. So cool. So, so cool. So first part of it was like, went through and he had, um, like a CNS pattern cleared that, and then the, his range of motion, 'cause he had like active plant affection.
He was missing like 50% on the involved side. He gained, um, about just a little bit there, like five degrees. Then went through the next round of LTAP, found a neurovascular entrapment down on the top of his foot. Literally skin lift 30 seconds, whoop, more plant reflection on the involved side than the other.
Like, I've never seen somebody's eyes just get so big outta something crazy. Right? And so like, worked with him, um, one time a week over maybe six weeks. And like he was back surfing, doing everything he wanted to do, like I love that. Went on a four day hunt where, you know, he's backpacking and rafting and stuff like that.
I
Anna Hartman: love that. Um.
Maria DelliVeneri: And it was just one of those ones. And again, we didn't
Anna Hartman: have exploratory surgery. I know. Oh my
Maria DelliVeneri: gosh. To like, to do what, you know, you're like, what? What, what's in the ankle that you would do? I don't know. Um, but yeah, so just one of those things too, not to like knock the medical system or anything, but I think it just brings up the bigger thing of like, people that suffer with pain for so long and try all of the things that oftentimes it really is looking through this lens of a neurovisceral.
Influence of it that can unravel or at least start to turn over some things. Yeah. Um, which is really cool. And so he obviously is like a wow one, but there's little things every single day that that happens. Um, same thing too. What I find, um, again, ends up. In my office quite a bit is like post total knee replacements that just no range of motion, like none.
And then they're always diagnosed as scar tissue, right? And so then they go under manipulations of anesthesia and stuff like that. And so often, you know, I'm always like, well, did they like do any imaging to see scar tissue? Like how do you assess scar tissue? Because like, yeah, how do you determine that?
And like your end field doesn't really feel like a scar tissue one. And it's like once you start. Like going through the LTAP. There's so many folks with that too that like once you start. Following through the sequence and start looking at the central nervous system, start looking at the viscera. You're all of a sudden I'm like, oh, there's an extra 10 to 15 degrees of flexion.
Oh. And not cranking on their knee, you know? 'cause it's like all those people walk in scared. 'cause they're like, I just had someone pushing on my knee and cranking on my knee and forcing my knee for months and months and months and nothing happened.
Anna Hartman: So they love when you can get range of motion without touching their knee.
'cause they're like, please don't touch my knee.
Maria DelliVeneri: Yeah, yeah. Like I just had someone put all their weight on it for months, you know, to no avail. So I think it's really pretty cool. Um, I think
Anna Hartman: that's awesome too. Um,
Maria DelliVeneri: and what's even. Pretty great here about being up in Bend is that we have so many, um, LTAP alums, and so it's a great referral network too, because, you know, there's other folks up here that have a different skillset and even another different lens to come into from massage area, from PT and the like of how they're utilizing it.
So it's just a different level with a little different skillset that like mm-hmm. Building that referral network too, of people that, again, are speaking your language and like they, they understand where you're looking. And then that way too, it just opens it up a lot more, you know?
Anna Hartman: Yeah. I love that you guys do.
It is like such a wonderful little microcosm of people in Bend mm-hmm. That've taken my course. Like who would've thought? Um, but I love that be, and you're right there is like every, there's like, I think every single one is a different type of practitioner.
Maria DelliVeneri: Mm-hmm.
Anna Hartman: Which is so cool. Um, yeah, so I love that and I love that you're all collaborating together because that's what it's all about.
And then, you know, and then that, that's the, I was just, I, I just taught this weekend and that's like one of the things I said is like the beauty of it. The beauty of the LTAP is, well, there's a lot of beautiful things about the LTAP, but one of the things is like one that I identifies, maybe some practice gaps that you might have.
Mm-hmm. In terms of like, yeah. Tools that you don't have that you were like, Ooh, this is a little bit of a. Um, area that I need support in. So can I find somebody in my community? You know, a lot of times for a lot of people coming from the ortho background, it's like not having a huge central nervous system treatment tool set, you know, for like cranial work or neuro manipulation.
So having other practitioners in the area that you can speak the same language too and you can. Refer and be like, Hey, I have this person that keeps coming up, central nervous system tension, and we're doing the, like, basic stuff, but it's not really sticking. Like, can you help me out here? Like, such a good tool.
Um, and then also, yeah, it's just, it, it is, you have the confident, like part of it is because it does get you the results. It does build your confidence so that when you know. Like you trust that? Yeah. The problem is the central nervous system tension or, or the visceral thing, like whatever it is. And you're like, I know it's this.
Mm-hmm. So I'm confident that I can refer to somebody else to help me and get the results for the person as opposed to, I think sometimes when we are not used to getting really good results, we're not confident that it really is the one thing that they need. And so we are so hesitant to refer them to someone else 'cause.
It. I think sometimes we think, think it makes us look bad. 'cause it, you have to admit that you can't. You know that you need help or like you can't figure it out or something like that. But this way it's like, no. You're like, no, I know exactly what you need, but I also know I don't, I can't do it. Mm-hmm. So like, here's these people who can, and then, then they go to that person and get good results.
And then your patient's like, oh man, Maria, she knew exactly what I needed. So like, they're gonna go back to you
Maria DelliVeneri: a thousand percent. Yep.
Anna Hartman: And I'm like, this is like the coolest thing ever. And so, you know, this is, you know, at the end of the day, a lot of people. Especially this in the podcast. I've heard my story like this.
This is actually why I am so passionate about putting this tool out here is because I want that level of confidence for a practitioner to be like, if it's not going the way I think it's going, I'm missing something. It might be a red flag or I might need to refer to somebody else because like, I don't want them to get in a scenario that my mom was in with her shoulder pain from her lung cancer that
Maria DelliVeneri: mm-hmm.
Anna Hartman: You know, when the physical therapy industry is used to getting 60% re like success rate as the norm, you know? Of course patients aren't gonna get referred back when they have shoulder pain. That doesn't get better because that's pretty standard,
Maria DelliVeneri: right?
Anna Hartman: And so it's like, no, I want, I want people to have amazing results all the time.
So on the few people that they don't, instead of like thinking that the patient's the problem. Mm-hmm. They're like, okay, I know you know this is not a normal shoulder. Then like, let's refer it back to the doctor or back to. Or to someone else, whatever, you know, a visceral practitioner or whatever. Um, you know, and have a better chance of picking things up like that.
And, and also just having a better chance of getting our people back to the things they love, back to surfing, back to the hiking, back to the climbing mountains, like
Maria DelliVeneri: mm-hmm.
Anna Hartman: Nobody wants to be in therapy.
Maria DelliVeneri: No. I mean, we're really
Anna Hartman: fun. We're really fun to hang out with, I promise. But also like, you don't really wanna hang out with us all the time.
Go outside and do your thing.
Maria DelliVeneri: Right. And I think that's the biggest thing too, is that, um, getting that part where. It's getting that trust to look at it through another lens and that confidence that people get it and 'cause they're like, oh, you really do care about me getting better and not stalling out at 60%, or not caring that I just fall off and don't come back for that part of it.
It's like you can say like, yeah, they're invested, like they're taking all this time for me to assess and really make sure a plan, and I'm seeing those changes right away. Hmm. Or enough of being like, they care enough that they're referring me out 'cause they want me to be part of the team and to get better for everything.
It's really cool. Yeah. Um, 'cause it's like, I think back to like working traditional athletic training where, you know, two hours before practice, all of a sudden you're bombarded with 20 to 50 people. Yeah. And if there was a way to like weed through those triage moments so much faster. Huge. Huge. Um. And even it's like, gosh, one of the moments that I remember, it was like I was a freshman so it was my first co-op working football season and like we had this freshman football player who ICE and him on his back for like the entire season.
Mm. And it's literally like, gosh, this is my first like introduction as an athletic trainer too. The profession. This is this kid's first introduction to like college football and like life as an adult. And I'm just like, we. Like, what other options do we have out there? Like, what else can we do? Rather than kind of like helping to like limp through the season.
Mm-hmm. And be like, oh is, you know, I could just imagine his shoes of like, is this gonna be the next four years? Like Right. This is my life as an 18-year-old. Mm-hmm. Sort of thing. But having ways there we could be like, quickly assess where to go and try something different because what has been happening hasn't been working.
Right. It's so powerful.
Anna Hartman: Yes. I love that. Oh, just we're out here just trying to change the healthcare industry. I said this this weekend at lunch with the participants. I was like, at the end of the day, like. I hate, we were talking about business model of like charging people, and I like, please don't do what I do because I am terrible.
I was like, I will treat too many people for free because I just feel bad that they're not getting good care. Right?
Maria DelliVeneri: Mm-hmm.
Anna Hartman: Through their insurance or through their team, or through whoever, and I was like, I just, I was like, I. I can't. I just can't. I was like, and also like I have a hard time charging a ton of money sometimes because I don't want to not let people get good healthcare.
And I was like, but at the end of the day, that's also why I'm so passionate about getting this to everyone because if this was more of the standard
Maria DelliVeneri: mm-hmm.
Anna Hartman: People would have better healthcare, they would have better experiences. With at, in the athletic training room, they would have better experiences in a high volume PT clinic.
Maria DelliVeneri: Mm-hmm.
Anna Hartman: Because where you start matters, like being able to listen to the body and figure out where the body is protecting can solve so many aches and pains quicker than this biomechanical lens that you're either like putting all your money, all your eggs in the basket of like their foot's driving it, their core's driving it, or like.
I don't know what's popular right now of everybody thinks is driving it, but, you know, so that is just like, yeah, I don't, I, I hate, I hate how good medical care costs so much money for people. Mm-hmm. I don't, I don't like that it prices people out that can't afford it. Like, everyone should have access to good care.
So, um, which is also why like. I mean, I love the free, not to plug the missing link, but I love the free missing link week that I do to like have people have a taster of the mm-hmm. LTAP online course because also I'm like, it's free and it like just knowing the first test of the LTAP. Like you said is a way to triage things so quickly.
Maria DelliVeneri: Mm-hmm.
Anna Hartman: And so I'm like, yeah, I will continue to do education for free for people because I really, like I said, I want the, I want healthcare to be better.
Maria DelliVeneri: Mm-hmm.
Anna Hartman: I, I don't want 60% results being good. I want 99% being good.
Maria DelliVeneri: And you think that's really the biggest thing, right? Is like. If everybody had the same set point of where we're starting and like everybody just kind of came in through that lens, then it didn't matter where you would go, you know?
Yeah. It's just like who's, who's around the corner, who's the closest that's there? Yeah. Because you know you're gonna get the outcome that you need rather than have to, like a lot of the patients I see go through so many different practitioners, and not that they did anything wrong by any means of it, it just wasn't exactly starting in the right place at these.
These folks need it. Exactly. Mm-hmm. Love it.
Anna Hartman: Well, I mean, clearly we could talk forever. Um, uh, but before I let you go, um, I think the last thing that I, that would be helpful is like, if someone was on the fence about joining the, um, LTAP level one, or even just starting with the free missing link, like, you know, what, what would you tell them to be like?
Be besides just take it like, like, like what are they waiting for sort of thing. But yeah. What would be your advice for somebody sort of on the fence and then also, I can't remember, I think you did both the online and the in-person. Mm-hmm. Yeah. So, and then maybe speak to that too of, um, the differences between the two and like what, you know.
Maria DelliVeneri: Oh yeah. Yeah, I was fortunate that I did the online first and then did the in-person. Mm-hmm. And what I really loved about the online is that you have this cohort that you're going through and you're meeting with for weeks on end there. So you're all. Mostly at the same starting point with this material, asking questions as a group together, bringing it up and seeing it at like a slow, digestible way.
Um, that really made like the implementation a lot less scary because of course, like. Gosh, I've been certified for so long now. Right? Like how many continuing education classes that you've been to and like, some of the stuff just comes at you so fast and like you're all in it, but you don't get time to practice or you don't wanna ask the questions or the confidence to go through it.
That, um, it just ends up with like another certificate that you put in for your Yeah. Um, that having the fact there where. It's broken down. You get the information, you get to ask the questions from you, you get the support from the people with you. Makes it when you go in person, like just connect so many different dots that are there because, um, as I was starting to implement, it was maybe, probably like.
Five or six months between finishing the online before going in person. So I had enough time to like start getting reps in and start having my list of questions of like, uh, I'm not sure about this. Right. So then when you're in person and you can see it and you can ask you live and then like be there live, you're like, oh, well that cleared up everything and made that nine
Anna Hartman: all my questions.
Maria DelliVeneri: Yeah, 9,000 times better. But you're right, because like
Anna Hartman: if you had gone in person first, you wouldn't have even known that those were your questions. You know? Mm-hmm. It is like, people sometimes are like, why is it the same course? Both. I'm like, because you actually do need that much time. Mm-hmm. To like fully integrate it and digest it.
And I was like, and I promise you, you know, you're, once you start doing your patients, it questions are gonna come up.
Maria DelliVeneri: Mm-hmm. And
Anna Hartman: the what ifs are gonna come up and the, you know, and I was like, and. There. It's also like, as you said, any con ed course, like people are lucky if they take home two things.
Mm-hmm. And so it's like, no, I want you to take home all of it. I want you to be able to feel like you can. Do it well the whole time. And so it's like, no. In order to be able to do that, we do need this, this seven weeks, like you said, makes it digestible so you can practice and work through all the kinks, come up with all the questions, have enough patience, like have enough reps for, for it to, you know, have the questions and not, and then also know that you're still in this learning phase.
So not get frustrated and just throw it out and be like, I can't get it. Because I think people, that happens a lot after Con Ed classes, it's try it a couple times. It doesn't make sense. You can't access the teacher to ask them questions and so you're just like, ah, fuck. Like I'm, I'm out. Right? So. So, yeah.
I love that you, somebody this weekend said that too. They're like, I'm so glad I did the online first before the in person and mm-hmm. Um, and on the flip side, I have people being like, oh, I love that. I did the in person and like got it in my hands. And then had the seven weeks of the online course afterwards to like to.
You know, digest it. And the cool thing with online course is it's lifetime access. So whether oh, huge. Whether you sign up and before and do it or don't do it, and then go to in person, and then you can always catch the next cohort anyway. So it's like you can always sandwich it all together. Mm-hmm. So, um, you know, I lo I, I love that and I, I, I do, I'm like.
Providing people access to me in the community so that they can have that support to integrate it, I think is like so important. And
Maria DelliVeneri: oh, it's huge. And it's even, sometimes it's just that reassuring part where you're like, oh yeah, no, your thought process is right. Like sometimes you just need that like little bit there to be like, oh yeah, no, you got the concept.
Yeah. Aspect of it. So I think like if you're on the fence, the, I think the biggest takeaway that I had that. Really came apparent once I was in it is that like it just made every tool that I was using, because like you always say, you have everything you already need for treatment and for tools and for all of that stuff that it's not another technique to use.
It's just like starting in the right place. So it makes everything that you're already doing, you just are speeding things up along in the timeline.
Anna Hartman: Yeah. I love that. Thank you.
Maria DelliVeneri: Yeah, thank you.
Anna Hartman: Uh, well, yeah, I've loved having you on here. Um. It's been great to talk to you. I love having you in the community.
Um, how can my people find you on, uh, the socials if they'd like to connect and ask you questions about either how you, um. Are, you know, doing your private practice as an athletic trainer or using shockwave and laser and or the LTAP in your practice? Yeah. Or patients who wanna come see you.
Maria DelliVeneri: Sure. So I am at Remedy Sports Med on Instagram and then remedy sports medicine.com for my website.
Anna Hartman: Love it. And we'll link that. We'll have Joe link that in the show notes too. But, um, yeah. Love it. Thank you so much.
Maria DelliVeneri: Thank you. And, uh, go Ducks, huh?
Anna Hartman: Yes. And go Ducks. Always go Ducks.