Dr. Jeff Musgrave // #GeriOnICE // www.ptonice.com 

In today's episode of the PT on ICE Daily Show, join Modern Management of the Older Adult lead faculty Jeff Musgrave discusses the brand new "Build your own older adult fitness class" starter kit now available on the ICE Physio App.

Take a listen to learn how to better serve this population of patients & athletes, or check out the full show notes on our blog at www.ptonice.com/blog.

If you're looking to learn more about live courses designed to better serve older adults in physical therapy or our online physical therapy courses, check our entire list of continuing education courses for physical therapy including our physical therapy certifications by checking out our website. Don't forget about all of our FREE eBooks, prebuilt workshops, free CEUs, and other physical therapy continuing education on our Resources tab.

EPISODE TRANSCRIPTION

INTRODUCTION
Hey everybody, Alan here. Currently I have the pleasure of serving as their Chief Operating Officer here at ICE. Before we jump into today's episode of the PTI Nice Daily Show, let's give a shout out to our sponsor Jane, a clinic management software and EMR. Whether you're just starting to do your research or you've been contemplating switching your software for a while now, the Jane team understands that this process can feel intimidating. That's why their goal is to provide you with the onboarding resources you need to make your switch as smooth as possible. Jane offers personalized calls to set up your account, a free date import, and a variety of online resources to get you up and running quickly once you switch. And if you need a helping hand along the way, you'll have access to unlimited phone, email, and chat support included in your Jane subscription. If you're interested in learning more, you want to book a one-on-one demo, you can head on over to jane.app slash switch. And if you decide to make the switch, don't forget to use the code ICEPT1MO at sign up to receive a one month free grace period on your new Jane account.

JEFF MUSGRAVE
Welcome to the PT on Ice daily show. My name is Dr. Jeff Musgrave, doctor of physical therapy, proudly serving the older adult division. And today is Wednesday. Wednesday means it is all things geriatrics. So it is Jerry on ice. I am super excited to be sharing with you today. some of the hard lessons learned and I think some helpful steps for building your own older adult group fitness class. So, getting more and more questions about this stuff, my business partner and I, Dr. Dustin Jones, who also is faculty in the older adult division, have built a community for people 55 plus and we have learned a lot of hard lessons along the way. I'd love to share those learnings with you and then also pitch a couple free resources that are coming your way that you can get when you download the PT on Ice app. So all that being said, super excited to share this with you, but we would be completely remiss if we just blew past and got to the nuts and bolts of building the program and not touch just a little bit on, oh, we've got some people on that are interested in doing the same thing. I love this. super remiss not to just share why we would want to do this. And the reality is, our older adults' lives are being destroyed from a lack of resiliency, that lack of reserve, that lack of extra physical strength. And it comes in many names, right? We like to call it one rep max living. We talk about limited reserve, limited resiliency. But they come in diagnoses like sarcopenia, right, dynopenia. We've got potentiopenia, that loss of power, loss of strength. We've got type 2 diabetes. We've got heart failure, cardiovascular disease, heart attacks. I know I'm preaching to the choir here, team, but it's just so sad to see the long-term outcomes and how that changes the trajectory of someone's life when we know that most of it's preventable. If we could get someone to high intensity, they've got a safe place to exercise where they can get the options that they need, then we could make these things go away. We have the solution. It's not like we're waiting on scientists to bring us a solution. We're not waiting on research here. The research is very clear that most of this is completely avoidable. Completely avoidable. So team, if this has got you pumped up, if you're curious about what it would look like to build this, I've got some simple steps and some considerations and then I'll share with you about a couple free resources we've put together for you. So the first step I feel like… We've got to be very clear about who we want to serve. You've got to know who is your best customer. Sometimes people will reference these as avatars or personas. Who is that person that you are best suited to treat? Who do you want to treat? The reality is, unless you're in a very rural community, a small community, you need to get very specific about who you want to serve. You need to know where they eat. You need to know what kind of car they drive. You need to know where in town they live. You've got to figure out where that geographical area in your community is you want to serve. You've got to know how to serve a very specific customer well. Let's be honest, the person that is maybe coming off of outpatient caseload, who is just barely above independent, community dwelling, older adult, Their interest in fitness and what is going to draw them in versus what's going to push them away is going to look very different than someone who has been a lifelong athlete, a master's athlete that's coming into your clinic because they've got an achy knee or an achy shoulder or something like that. I mean, those customers are going to be interested in a different intensity. They're going to have interest in different equipment, and we need to know how to speak that language. We need to know how to identify that very specific customer we want to serve, and then we've got to create an environment that is irresistible to them. It's got to be equipment they can use. It sounds like such a simple thing, but it's all fun and games in your older adult group fitness class until you try to get someone on a bike and you realize they physically can't get onto an assault bike or they physically can't use a rower anymore. What are you going to do with them during that class? Do you have a plan? But that is a completely different customer that's more like that person that just came off outpatient caseload versus someone like that Masters athlete where they're going to be able to use all the equipment that the general population in a CrossFit gym is going to be able to use. But you've got to be very specific about who you're going to serve because I truly believe you cannot serve everyone well. You've got to be very specific. You've got to niche down as much as possible. If you're in a small rural area, you may have to widen your lens just a little bit more, but be very specific. So the who is the first part. You've got to know who you want to serve. The second part of who is with whom. So the with whom is, are you going to do this alone or are you going to find a partner and partner with somebody? I'm very excited to say that I've got a wonderful partner. Dustin Jones is gonna be really upset that I said this, but I trust the guy with my life, okay? I don't have to worry about the decisions he's gonna make for our business. He is a very strong, has great character, he's dedicated to excellence, and he's gonna challenge me. He's gonna push me. outside of my comfort zone based on the mission that we're serving and the people that we're serving. And that is crucial. A great way to summarize that goal, and depending on the project you're trying to put together here for your older adult group fitness class, you may be able to do it solo and that may be fun. But I'm gonna give you some advice via Jeff Moore, via an African proverb, and that is, if you wanna go fast, go alone. If you want to go far, go together. And we found this true because we launched right before the pandemic. And I think if we hadn't had each other's support, there may not have been a stronger life. And man, what a huge missed opportunity that would have been to the people that we get to serve. So that's the first part. Who and with whom is what you've got to figure out. The second piece is you've got to know, you've got to start figuring out what model you're going to use to serve in this older adult fitness. You've got to figure out your space. You've got to figure out your equipment. So if we're thinking about different models that are out there, you could, um, Start like we started in a CrossFit gym, maybe in off hours. You want to make sure it's a place that's supportive. We were lucky that we were at CrossFit Maximus in Lexington, Kentucky, and they were all about having us in there during the hours they weren't using class. The equipment's there, the space is there. Team, these business owners, they're paying the rent. They're paying utilities through this whole time, but they're not getting any income during that time. Usually what you're going to find in those gaps, mid-morning and early afternoon, are you're going to find open gimmers who are paying the maximum price, but they're using maximum equipment, maximum space. And if they could get someone that was going to generate exponentially more income during that time, they'll probably take a shot with you on that. So that's one way you could do it. You could also choose to do a virtual model, where maybe you're using Zoom or you're using Google Meet, and it doesn't really matter where your customer lives, as long as your customer's tech savvy, right? They could be all over the world. So you're probably gonna have to build some type of following. You're gonna have to get your name out there. But a virtual model frees you up from having to have a brick and mortar space. It can free you up from the geographical barriers of not being able to get to your customer or your customer get to you. A lot of studies say people are only willing to drive 10 to 15 minutes for their group fitness classes. So if you take wherever you're targeting to put your spot, and you kind of draw a circle, that's how you can start looking for real estate in that market as well. You need to figure out, are you going to do only group fitness? Are you going to do personal training and offer one-on-one sessions? Will those be in person? Will those be online? You can mix and match these things as they meet your needs and the person you're trying to serve. Is that a good method to serve your ideal customer? So something that's probably gonna ruffle some feathers is equipment. So this discussion about equipment and space. So the thing we've got to get focused on is being focused on results and serving that customer well. Every piece of equipment that you find will not necessarily serve your customer well. Can they physically get on it? Can they use the piece of equipment? or not. You've got to figure out weight limits for things. Are you going to serve customers? Are you going to serve larger bodied athletes and patients that just came off caseload? Kind of like the C2 bike. I think the post can only hold like 200 or 210 pounds and it's tiny. If you're a larger bodied athlete, that is super uncomfortable. and you're probably going to break the equipment. Can you think about what's going to happen to your business early on if one of your larger bodied athletes breaks the equipment in class? How embarrassing that's going to be for you, for them? That story, unfortunately, is going to be shared very quickly and probably very widely. So you've got to figure that out about equipment, but also how much space does that equipment take up? How many people can use it? And is it gonna be an attractor or a detractor to your target avatar? Now, if you're working with more of a master's athlete population, they've been in the weight room before, they're maybe not gonna be upset about seeing dumbbells and barbells and all these different pieces of equipment in the environment that seems a little bit harsher, a little more, well, most of us would consider pretty badass, right? But you've gotta consider in a group environment, if you're trying to onboard people, that are terrified of a barbell. They've never seen it. Say you don't have training bars. Man, this one hit us really hard. We didn't have enough training bars when we launched. We had several members that couldn't even get the empty barbell out of the holder and move it to their spot. We're trying to build autonomy. We're trying to build their confidence and their strength. They can't even move the frigging piece of equipment around. Like, how upsetting would that be? You're terrified. You go to your first group fitness class and not only can you not use a piece of equipment, you can't even pick the thing up. It was, man, lots of hard lessons learned there. But we want to figure out with our model and our space and our equipment, how are we going to use these things? Does everyone need everything all the time? Do you need, if you're going to do a class of 15, do you have to have 15 rowers? Do you have to have 15 Ski Ergs. Do you need 15 GHDs? I love GHDs. They're fun. I use them all the time. But they're not the best to serve our avatar at Stronger Life. You will not find GHDs lining the walls in Stronger Life. Most of our members would not be able to use that piece of equipment. And it wouldn't give them the most bang for their buck on their time. So you've got to figure out, like, how accessible is your equipment? How much of it do you need? programming for stronger life, and the reality is you can program these problems in, or you can program these problems out. I mean, if you do a, if anyone is in the CrossFit space and done, shoot, Filthy 50, man, you gotta have a box, you've gotta have barbell, you've gotta have jump rope, you've gotta have rig, you've gotta have all these things. Like, the amount of equipment and space you need is incredible to run that class, if you're thinking about building out your own space or leasing your own space. But think about a workout like Fight Gone Bad, where you're rotating through stations. You need a fraction of the equipment, you need the fraction of the space, and if anyone's done any of those five gun bad workouts, you can get a tremendous workout that way. And I'm not saying that's the only format, but that is one example of where you can program in lots of expense, lots of overhead cost to make it really hard to open your space that's gonna push you into a much larger footprint than you need, and then you're gonna have hanging over your head a big lease a large utility cost, insurance, just the whole thing. And the more equipment you have, the more you've got to buy and the more space that takes up. So this takes me to a term when we're trying to consider all these things and figuring out if we can build a profitable business, we've got to consider things like operational capacity. So operational capacity is when you're looking at your space and you're trying to figure out, okay, I've got, say, 3,000 square feet and I've got this many square feet of bathrooms. I've got this much square footage in the lobby. I've got this much square footage for equipment storage. How much of the space that you're going to be leasing or using can actually produce income? You've got to figure that out. You've got to know how much revenue you can produce in your space, how you're planning to program with your customer. Because if you don't know how much income you can produce, like maximum capacity, then I mean, we've kind of turned this into like a volunteer job, right? And there's nothing wrong with that if you want to volunteer and do this for free. But if you want to build a healthy business, you've got to figure out your operational capacity. And this was first, I learned from Stu Brower's podcast, WTF Gym Talks. Now, if you don't like four-letter words, you may not get through his podcast episodes, but some very savvy business learnings there. WTF Gym Talks, Stu Brower. Brilliant guy. He's actually got a short episode on that that is really helpful and very eye-opening. I actually go through an example of looking at different operational capacities on the free resource on the ICE Physio page I'll tell you about at the end. So, that leads me directly into profitability. The reality is, team, if your business fails, you can't help anyone. So do your math up front. Figure this stuff out. Who am I going to serve? What kind of equipment am I going to use? What do I have the capacity? How many people can I serve? You've also got to figure out your pricing. You've got to be reasonable to the market, but also value what you can offer as a physical therapist or a physical therapist assistant or a fitness pro that has gone through older adult training to know what in the world is going on. What we need here is we've got to figure out where that intersection goes. When are we going to become profitable? Based on the number of people I can serve, how much I can charge reasonably, how soon I think I can fill this out, when can I expect to not be losing money but making money? And we've got on the PTI and ICE free resources, you can get access through the ICE Physio app. We're sharing with you a break-even spreadsheet where you can put in all your costs, what your pricing is, how many people you're expecting to serve. to figure out how many weeks until you have a break even point, when you're not losing money, but you're actually, you're floating. And the reality is this idea of reserve and resiliency dovetails very beautifully. with a business. If you've got high financial reserve, you're making way more money than you're spending, then your business is profitable. If your business is profitable, then you can invest in more equipment. You can invest in more advertising. You may be able to bring on a second person to help you or another coach that you can train. Those things are beautiful to be able to consider and to be able to share this dream and this vision with someone else. We like to call it building a bigger table, dreaming big. I would argue to say, once you have some level of success, you should be thinking about how you can share these opportunities with other people around you who are also passionate. But you've got to figure out the break-even point, and that can also help you figure out what profitability can you expect at a certain price point at a certain membership level. So once again, that's on the Ice Physio app under free resources. you can get access to that.

SUMMARY
So what we've actually got, I've got a lecture that's a little bit over 20 minutes long, going through these items in detail with some more examples of what your operational capacity would look like, what your profitability would look like, based on two different models, more of kind of the extremes like, master's CrossFit class that everyone needs a barbell everyone needs a rower and then an example of more like a cycling studio where it's like you've got a very small footprint you can really pack the house so you can kind of just see compare and contrast. I'm not saying either one is right or wrong it's just you need to be informed before you make decisions and move forward. You've got to know who you're going to serve and with whom. Are you going to do it solo or are you going to partner up? You've got to know your model space and equipment, a.k.a. the operational capacity of your business, if it's going to survive. You've got to figure out how long until you become profitable, how your equipment, how your programming feeds into whether you're going to be profitable or not. and make decisions as needed. You need to know your break-even point. That's going to give you your financial runway. How long can I operate and keep this dream alive financially until I've got to make money? And you can't do that with rose-colored lenses, team. You've got to take a hard look at the numbers and repeat these steps as many times as possible until you've got something that's really going to work. So team, that's it. All of that is wrapped up in more detail with a free lecture and that spreadsheet to figure out your profitability. That is the free starter kit on the Ice Physio app with the free lecture. Should be very helpful. So please check that out. Reach out to us. We'd love to hear your thoughts or questions. I wasn't able to keep up with the comments. I probably didn't answer any of your questions live on the call. I love that you ask questions, but please ask them in the comments and I will get back to you. If you have questions about this stuff, I love this. This is my passion, getting to live my dream. Love this. Check out the free resources. Ask your questions in the comments. If you're looking to see us from MMOA out on the road, we've got a few seats left in Level 1. That's going to get started on the 15th of May, so grab those seats. Level 2 already sold out this cohort. You're going to have to wait until October if you're trying to get into L2. Don't let that happen if you're looking for L1. Live on the road, we're going to be in North Dakota and Richmond, Virginia in the middle of May and then Scottsdale, Arizona early June. Team, I hope this was helpful. I hope this got your wheels turning. Check out those free resources and we'll see you next time.

OUTRO
Hey, thanks for tuning in to the PT on Ice daily show. If you enjoyed this content, head on over to iTunes and leave us a review, and be sure to check us out on Facebook and Instagram at the Institute of Clinical Excellence. If you’re interested in getting plugged into more ice content on a weekly basis while earning CUs from home, check out our virtual ice online mentorship program at ptonice.com. While you’re there, sign up for our Hump Day Hustling newsletter for a free email every Wednesday morning with our top five research articles and social media posts that we think are worth reading. Head over to ptonice.com and scroll to the bottom of the page to sign up.