Pearls of Myofascial Release
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[00:00:00] Hey there, it's Hoang with Hand Therapy Secrets and welcome to my show where I want to share with you different techniques, different people, and even tips that you can use right away in your therapy practice. So this episode is going to be talking to a good friend of mine. She is a physical therapist.
[00:00:18] Her name is Jessica, and she specializes in myofascial. So stay tune. You're gonna hear a little bit more about how she works in her practice, how she works with OTs that specialize in the same thing. She does myofascial release and share with you some tips that you can use right away with any of your patients.
[00:00:38] All right, enjoy the show. Welcome. My name is Hoang with the Hand Therapy Secret. This is my good friend, Jessica. Jessica, I'd love for you to introduce yourself to everyone who watches this majority of the time. People who are here watching hand therapy secrets, they're occupational therapists, occupational [00:01:00] therapist, assistant, physical therapist as well.
[00:01:02] But everyone here has an interest in specializing in hand and upper extremity types of issues. But no matter what the background is that they are really interested in upper extremity types of issues. So tell everyone a little bit about you and where you are and your company. Yeah, absolutely. Thank you so much for having me on Wang.
[00:01:23] It's a pleasure to be here. My name is Dr. Jessica Papa and I'm a physical therapist and I specialize in treating patients with chronic pain. I often see folks who have tried a lot of traditional methods and they often say they, they've , looked on their own. They've searched for relief and, finally they make their way here, which we're trying to change that.
[00:01:44] So it's more of, not a last resort, but a first choice. Yeah, for sure. Yeah. And I also treat. Pelvic health conditions and concerns. I specialize in a technique called myofascial release, and it's something that I, as a [00:02:00] physical therapist can do, but OTs can get certified in it as well as even speech therapists, believe it or not, cool. The fascial is everywhere in the body, so when you really. Think about, and that's really one of the reasons why I wanted you on the show is because as a certified hand therapist, we deal with a lot of people with chronic pain. Like I just taught on C R P S, which is a chronic pain type of issue.
[00:02:24] The majority of the cases tend to be like post. Distal radius fractures, but you can have CRPS on any part of your body that has a fracture, has an injury, or anything like that. Absolutely. And what do you, so one of the things that I wanted to do also was I wanted you to come on and tell a little bit more.
[00:02:47] Your specific technique, but potentially even share with the therapists who watch like something that they could use right away? Absolutely. I'd be happy to. And it could be in any part [00:03:00] it doesn't have to be the hand, it could be something with the neck or the shoulder, the elbow, something that, that that the therapists who are looking and watching and want to learn, that they could almost take back and use right away.
[00:03:14] 100%. I would be happy to. And one of the best ways to learn is to treat yourself. So I have thought of a few good things to share with all of your listeners and followers, so we'll definitely go into that. And to get to your first question about what is my fascia release? Fascia, like you said, is basically what we're made of.
[00:03:34] It's about 70% of what makes up our body and it lays over muscle. It's a first layer. If you can all see the orange behind me, that's how I explain it to my patients. Might be a good analogy for everybody listening. I always wondered what was up with your I know. So Aranka. No. And how do you even say the name of your company, like your physical therapy.
[00:03:55] The Italian way would be acha, but I say irania, it's easier for people to [00:04:00] understand, and it means orange and Italian. I'm Italian, so I had to throw that in there. Awesome. You're Italian. No. Three quarter.
[00:04:15] So my greatest friends are Italian absolutely. From Italy, I'd like to have easy ways for patients to understand things and break it down simply. Yeah. Yeah. Okay. The, like the segments of an orange is how you Yeah. So basically if you think of that clear layer that covers each.
[00:04:37] that's how I explain the top layer that lays over muscle like a piece of chicken. Even the clear over that, the casing over that. So much nicer . So if you think of that clear layer, it's like that superficial layer of tissue. Yes. Body, but it goes all the way down to the depth of our body is also known as the ground substance.
[00:04:56] But if you think of it as orange, that outer white. [00:05:00] Layer that's dried out. That's like the deepest layer of our body, which gets solidified over time as it's depleted of the hydration that we're made of water. And so if you think of different things in life, like maybe patients come to hand, therapists after surgery or fall or trauma, and they're like, Yeah.
[00:05:19] That layer all the way down to the cell level gets very gunky and dried out. Yeah. My fascia release can help restore the natural fluidity of the tissue and bring back the gelatinous layer that fluid layer of tissue so that when we move it's not painful and we don't have. Tightness and tension, but it's more fluid in nature because that's largely what we're made of as well as water.
[00:05:41] But we can't just drink it back. We can't. Do you still tell your patients to drink water though? It's good. It's, water is awesome to drink, but when you have these, it's not the cure for the restrictions. It's Yeah. Gonna just be like pouring water over a rocket. It'll just slake right off the surface because we have all these [00:06:00] tight, gnarly restrictions.
[00:06:01] Yeah. Get way and it's, solidifies our system. So when we do authentic fascial release, It helps to open up the space in between. It's also known as the interstitial. Ah-huh. So that connective web starts to have space, so as you drink, the water will permeate through down to the cell level. And really we restore runs such at a, such a deeper level.
[00:06:20] Cool. Awesome. So fascial releases a wonderful tool to add to your treatment program to really understand that it is the only system to touch all the other systems in the body, which is really cool to think about. So it lays over muscles, so you can't really have full strength of the muscle if you have fossil restrictions that lay over it.
[00:06:42] Nervous system. So even just I'm a huge nerve person. Yeah. So think of a fascial restriction in the neck and shoulder area, right? Maybe like a high scapular. Yes. It can equate to up to 2000 pounds of pressure. Per square inch on any pain sensitive [00:07:00] structure. So crushing pain, that's two horses on your shoulder.
[00:07:04] Oh, imagine all the nerves laying under there are just hyper excited because you have this nasty, gnarly, fascial restriction. Yeah. Line for it, which in turn is affecting your hand and causing you to drop things, right? Yeah. And we might think oh, your hand is so weak. Address the hand right away. Yes.
[00:07:22] What about this gnarly restriction up here that's putting so much pressure on the nerves and muscles that then cause you to drop things? So really teaching therapists to look for the symptoms, but we wanna look deeper for the cause. We can treat the symptoms. We wanna look elsewhere for the root cause.
[00:07:38] And. . It's really neat in terms of muscles and the origin insertion of things when we, know from our training in school that we have to memorize everything, our, all the origins, insertions actions. But when it comes to tissue, it's a one, it's a unanimous web from head to toe. So we talk more in terms of regions because a shoulder restriction.[00:08:00]
[00:08:00] It's not gonna be necessarily on one part of the shoulder, it's gonna be global. It's gonna neck the shoulder, the wrist, probably all the way down. Yeah. Possible to pinpoint a specific nugget of tissue. You know what I mean? Yeah. A huge effect on the whole system. When people find you, are they looking for a specific technique?
[00:08:27] or are they like, are they aware that you do myofascial or are they just coming to you cuz they have chronic. So it's a little split right now. A lot of patients find me organically on their own because they want a holistic approach and they want to find relief, but not short term. They want long-term lasting relief.
[00:08:50] So those are the folks that kind of search me and find me on their own. But then I have a another pocket of therapist. Our patients rather that find me on a therapist directory that [00:09:00] just vocalizes in this approach and they come say, Hey, I know you do this. I just want this. I know it for me. So they're, two different types of patients, but they're all in chronic pain.
[00:09:11] Yeah. So it's very similar to how people will find occupational therapists who are certified hand therapists. We're in a, if you are, if you become a certified hand therapist, you go onto a database. But we certified hand therapists tend to be known for post-surgical stuff. Okay. They tend to be sought after for post-surgical stuff, and I'm a huge believer in.
[00:09:38] Like I did a video, I think talking about like the piece of the pie, like most of the time there's people who have injuries. They fall they need surgery and stuff like that, and that's just one piece of the pie. But there's all these other people that have chronic types of issues and they just, if they keep going to a [00:10:00] very traditional base mill of a clinic, They're not necessarily getting someone who's gonna look at everything and dissect it from those levels.
[00:10:11] Absolutely. So you guys as someone who's myfa specialize, you have a database too, and that's how people you don't have to be on it, but I would highly recommend being on it because it's one of the things that distinguishes, what you do. And just like you said, a patient has had surgery, OTs are in an amazing position to do some, really different techniques that people might not understand or think of as a, ot.
[00:10:36] But this is the thing. Yeah, and it's not OT pt. It's I wanna help someone to become more independent, to live a certain lifestyle without pain. So I cater to I. It's funny I say I cater to an older population, 40 plus, but actually we get a ton of young people and we got a to young ton of [00:11:00] young people with nerve types of issues.
[00:11:02] We deal with a lot of nerve entrapments actually have someone who came in, she actually came to me a year. . And she was very much I wanna do everything on my own. She wanted to do a one time thing and that was it. But she came back recently and she has numbness in her thumbs and I just had t on the different nerves and so I was able to rule out all their nerve issues.
[00:11:32] I was able to rule out carpal tunnel issues and I knew from the thumb that it was a radio nerve type of issue. , but she was so restricted and I couldn't pinpoint she had neck, shoulder and thumb, and she doesn't have pain, right? So sometimes we use the word pain, but they're just uncomfortable, right?
[00:11:54] It feels really tight all the time. And she had very specific numb. [00:12:00] and I was like, okay. Like I knew it was a radio nerve type of issue and this is how she would be. She was like, if I bite my thumb, split normal here, and I do it on this side, it's numb. So I told her, yeah, we gotta find out where it is getting in trapped.
[00:12:19] Anna, what, what's entrapped? Where was? And one of the hardest things is that they have to understand it's not one. And I love that you're highlighting that because for anybody, especially the new Gros, who might feel that pressure to get somebody, finished with their plan of care quick.
[00:12:37] Yeah. Yes. Now you're feeling it, but you have to remember and really do your part to educate your patients and let them know that this didn't happen yesterday. It's not gonna get fixed overnight. And if you do want a quick. You might not be in the right place cuz you're not quick fixes. Yeah. Do you often also tell them that it probably predated when they started to feel it?[00:13:00]
[00:13:00] Oh yeah, because it's literally what I always explain to my patients is what they come in for is usually like the needle that, threw them over the edge. It's literally the needle that broke the camera, the hay, whatever. What's that? I can't come up with the same right now. You know what I'm talking about
[00:13:19] So it's usually, you have to peel away the layers. And I like to use a layer analogy again because what they feel when they first come to you is the last straw. And yes, they forget because they've numbed it out in the beginning. They've pushed through it, no offense. But men, a lot of times men mask it or they, they.
[00:13:36] You know it's gonna get a better the next day. They can both through it and yeah. It's just not, the pain is your body's sensation to withdraw. So when you feel something that's less than pleasant, it's a signal that your body's trying to tell you. You have to listen to that.
[00:13:49] Otherwise, yeah. You hurts and you don't understand why. What do you say to people when they're, do they come into you for numbness or do they come into you? Do they [00:14:00] come into you for sensory disturbances or do they just come to you for. , all sorts of things. I've got patients who have, numbness.
[00:14:07] I have patients that, so what do you say about the numbness? What do you say to them when it comes to like numbness stuff? Same thing is we have to detect where it's all originating from. So we're. Peeling away the layers. We're figuring out, like you mentioned, if it's the thumb, if it is radial nerve root, or for me, my first, thought was okay, she probably has several anterior transverses processes that are rotated.
[00:14:31] We have to take the snags out there
[00:14:35] and it kills me, but they always go for the back. You have to get in the front because this is the area that's getting short. And so I wanna hear. Yeah. So see how, we're getting to the same thing, right? We know it's not from the hand, but our approaches are completely different. But and I was working her next but she was definitely entrapped in her dump, but, I want you to tell me your anterior approach.
[00:14:58] Share that with us. [00:15:00] Yeah. So after I've done a full posture and assessment, what I do is I take a view on my iPad in four different ways. I will review it with the patient and then we agree together, Hey, here's where it's probably coming from. Okay. So after, I wanna just say this. After I've balanced the pelvis, then I work my way up to the neck and the thoracic, I clear the thoracic diaphragm and then I go higher up.
[00:15:21] Okay. Looking for that nerve root specific, and I'm gonna use my thumbs and I can check on myself first, but I'll go, right behind scm, posterior to it. Okay. How feeling on the patient when they're laying down on their back. each one, and I'm feeling for the heads of those transverses processes.
[00:15:39] Okay. What I wanna do is I wanna feel which side is higher, yeah. The side or the left side and Right. Usually you can tell by the pelvis, they mimic the pelvic alignment. And so it's so easy once you soften your focus with the posture assessment to get a sense of what side might be rotated in the neck, which affects everything distally in the shoulder and arm and [00:16:00] hand.
[00:16:00] But when I'm feeling for those snags and rotations, The thing that I don't ever wanna do is force them back to being neutral again. I'll go in the direction that, of course this is all through training that you learn in the Barnes of my fascial approach, but we're going in the direction that it's already going first.
[00:16:17] Because if you think of a stuck drawer, sometimes it's helpful to push into that stuckness. Yes. Up and that's what we do with the body. We never. Abruptly against the direction it's already going. But once we held it in the direction, let's say it's rotated anteriorly, we're gonna go in that direction and wait, yeah, we'll go into the opposite direction and it eases up so much faster and longer lasting because we didn't force, if you find force and it's such a tender area anyways.
[00:16:45] Yeah. People brace and then that's gonna prevent you from doing anything. Yeah. Beyond. It's the same idea of you're pushing into pain, you're gonna just get more pain and a fear of that pain and guarding. So you're actually pushing into an [00:17:00] area that feels good for somebody. Your body's already doing that and then it's gonna relax and then you could.
[00:17:06] Pull it out of that gene. You really like I was saying, to try things on yourself. If you go back right by where the ma side process is, I just take, two fingers like this and I go right behind. And I first go inward. You can feel that. Space there that ha it's like a squishy space.
[00:17:21] Show in and that's like where we have 13 different neck muscles that attach on either side. It's a really therapeutic release for people and on ourselves. But what I do is I trace all the way down. So I'll come all the way down the front of the neck. And you have to be careful.
[00:17:38] Obviously the s SCM is there. You just stick straight out. Where is mine? I fixed that shit and now it's yeah. So for all the viewers just turn your neck and you'll be able to feel that SDM kind of jut out and go right behind that, find up to the process and you really wanna just glide down, think of the, as [00:18:00] like two escalators and you're just shutting down and you're feeling where you get stuck.
[00:18:05] , it's right here, so I'm gonna wait. and be gentle, but you're gently compressing in and slowly your hands will go down on their own when the tissue releases. But it's a really great way to open up the front of the neck. And the more important thing is you're assessing what tissue you know is stuck and what needs to be released so that you can go back to it and find a snag with the transverse process.
[00:18:31] So the terminology you use the is a very mulligan. ? No, I've are you, do you do Mulligan too? I have taken Mulligan courses, but I blend the terms and I shouldn't do that, but no, but you can, but I just find that there's certain packets of people. I've been a therapist for a long time, so I've taken a lot of different courses.
[00:18:52] But I, it's funny cuz when you're a new grad, and I remember being a new grad like you're just so overwhelmed with [00:19:00] so many things, . But then after a while, you start taking it and you're just trying, like for me, I, I try to find a lot of commonalities in stuff, and I find that you just find the approach that you like just naturally gravitate towards.
[00:19:15] Absolutely. And then you'll see that certain things are just very similar, like the myofascial. Is again, moving into the good side. So I'm a total motion release person. I don't know if you've seen the T M R stuff, but they do more active stuff, but they always do the, move into the yummy side, move into the good side.
[00:19:36] And there's a lot of things that talk about that a lot of different techniques that talk about. Moving into the good part, moving into the side, the area that doesn't hurt. The least side does hurt. So it's, that's very similar in that myofascial aspect, right? Similar in, in that respect of, not wanting to go directly onto a pain sensitive [00:20:00] area, if you.
[00:20:02] address the areas around any painful structure, it's gonna help that painful structure. It's gonna help loosen that indirectly. Yeah, and if you can only start with an indirect technique, the patient will feel more trusting in you and more relaxed. And it'll help desensitize the other tissue. Yeah. Now, like you mentioned crps, let's say you had somebody like that who you can't even go near them sometimes.
[00:20:22] Yeah. Have a patient who was bit by a dog and got it. Yeah. So I wouldn't touch that side. I would always work on the opposite side, balance the pelvis, and, finally know we can work above and below on that, where the bite was Right. She's slowly getting, confident, putting that foot down on the ground and, she's made tons of progress, but it's not like an overnight thing because it's day to regenerate.
[00:20:47] Yeah. But the more you can teach them to do on their own, the better they're gonna get there. Yeah. No, absolutely. Absolutely. Very cool. That's nice. I think people are gonna be able to do something specific with [00:21:00] what you showed my lady, huh? Back that real quick because there's one more thing that you can do in addition to that.
[00:21:08] Oh, okay. Nerve patient. For herself. So I'll just turn my cameras on a little bit. And this is a really great wrist extension sharing technique. Okay. So if you can the wrist, and this is also great for the desk workers, typers. , or even people that are on their phones a lot is that you wanna open the wrist.
[00:21:28] this way, and what I usually have people do is if they're in a sitting position, I'll just tilt, I'll stand, believe like I'm sitting, but I'll have them rest their elbow on their knee this way, their hip, and I'll have them open up palm on palm. But so you can see you're getting into that carpal tunnel.
[00:21:44] Yeah. And the Retin AUM is there, that thick band that lays over the nerves. So you're opening up, but what you do. . The reason why it's hand in hand. You're compressing first, and then without sliding or gliding the direction's going down. What your maintaining contact is the stretch [00:22:00] piece. The difference between myofascia release and most therapies is that we're not using any sliding or gliding.
[00:22:07] It's constant compression stretch combined, but without any. Movement like this. Okay. Literally. Ah, okay. How much pressure, cause I always hear my fashion stuff is being very light. Okay. I'm really glad you asked that because this is a misconception and I wanna clear it up. For anybody listening tell us authentic.
[00:22:30] My fashions lease, I'm talking about the John Barnes approach is 20 mill, ah, millimeters market . So we. . We don't wanna do five, we wanna do 20 pounds of pressure per SCO inch, because if you're under that, it's very like surface July. Yeah. It's not enough. It's like similar to there's another gentleman's approach, the cranial sacral approach.
[00:22:55] His is very light and it's still good. It's just this [00:23:00] approach goes down to the depth layer and we all. Individuals have a different depth barrier. And what I mean by that is for you, let's say I treated your shoulder and I, what I would do is compress down into the shoulder and I would wait until I feel a natural stop.
[00:23:15] Think of like your hands sinking into singing. Yeah, feel that natural stop. We don't wanna make you brace and tighten, but where we feel like, we'll, some more room to go. Yeah. That's where we hold the steps and then we apply the stretch at the same time. Yeah. And the time is another huge component. It needs to be a minimum of five minutes or more.
[00:23:37] Ah, and within that time, that's when interleukin eight is released from your body, which is your body's natural anti-inflammatory releaser. So instead of having, pain pills and anti-inflammatory, yeah, you're gonna have your body released it naturally and it. A phase transition, basically that happens after about 90 seconds.
[00:23:58] It's called pizo [00:24:00] electricity. So pressure electricity that happens, which kicks start the next phase where your body starts to open up that interstitial web. . So how does that web is opening your hands and you can sense the tissue softening, but that's like the fool's goal. That's where most people would give up.
[00:24:17] You wanna maintain that compression for at least five minutes really. So their body can have that interleukin eight released. And that's. the best thing that could happen to help. So it's very, it's a su, it's a sustained pressure, basically. It's, yeah. So there's not a lot of oh, let me move all over the place.
[00:24:36] Let me push and pull . And that's something that's really important for the therapist listening to know, because we all wanna be doing something. But yeah, it's that sensation of I'm doing a lot. Yes, if you can do a lot with doing very little you're doing so much and the best thing you could do is really take a class.
[00:24:56] If you go to the website, my fascia release.com, you'll see [00:25:00] them there. But it teaches you how to really be patient and help better. Teach you how to feel because if we're talking, if we're, trying to keep the patient entertained, we can't fully focus on what we're feeling for one, and they're not either.
[00:25:15] Even though they might say they are, there's no way they can. So it really teaches us to understand what's going on left brain and explain that to them, and then when they're trust, but then turn the right brain back on. More, and help to soften into what you feel so that you can be more perceptive on those subtle releases in the fasha.
[00:25:35] , also see where the rest of their body is responding. Because another thing that happens is just pretty cool, is a vasomotor reaction where blood comes to the surface, right? , so I'm back on a region, the rest of the body can light up. For an example, I had a patient who came to me for chronic back.
[00:25:52] I was working, doing a luo sacral decompression and all this area got beat red. I could feel the [00:26:00] heat. I could see the heat. I didn't, wow. See hey, you're right, bright red. But I, later on, I, she dialogued both me and she revealed that she had a trauma and she was, abused and there was more to the history that didn't automatically come up.
[00:26:12] Yeah. So you always have to have your, you. Scanning eyes on because there's things that we can't see over clothes. It's great to have a tank top on or short, so you really see the skin. Yeah. Patients aren't gonna always come out and tell you these things. It makes a big difference with the treatment approach because if it's a chronic pain patient, especially these emotional holding patterns can strain us physically, and we don't mean for them to, but it's the mind body connection that we also need to be aware of for chronic pain patient.
[00:26:44] Yeah. Cool. What I'm gonna do for this video, I'm gonna include your link of, can I include your link of your company of your website? That way, if there's, where are you located again? We're located in Cranston, Rhode Island. Okay, there you go. [00:27:00] So if there's any occupational therapist or physical therapist or wanting to reach out to learn more about Myofascial, they could come to you and do you have a YouTube channel?
[00:27:11] We do have a YouTube channel right now. It's Irania Physical Therapy. You can find on there. Our website's, irania physical therapy.com. We're on Facebook, Instagram. Awesome. You can sign the book on Amazon. Yes. Show me your book. Book. Yes. This is the book, conquering Mystery Payne, how my Fashion Can Help Heal You.
[00:27:33] And this is a really. Book cuz you can flip around. You don't have to go in order. Okay. You can make, find a diagnosis that interests you or there's also 10 therapists, some of my closest colleagues that share their stories in here, as well as six or seven of my own patient stories. A lot of science.
[00:27:50] I made sure to beef it up with the research. Okay, so I think something for everybody, there's two great OTs in here, so yay. I find that a lot of [00:28:00] OTs are. Going into, so you say you do a certain amount of pelvic health, and I find that. So OTs have always done for the longest time bowel and bladder types of issues.
[00:28:12] They've always spoken about pelvic health, but in a more functional way. And I think it's not as sexy to talk about bowel and bladder , but OTs have always spoken about it and treat it in a in a very specific way. . But it's all relatively related. But now they've I'm noticing more and more OTs going into that pelvic health type of history because it is beyond bone bladder cuz they, they, OTs talk about sex and stuff like that too, but pelvic health is a little bit more all inclusive of that.
[00:28:47] And as an ot you really can do everything at PT can, it's really like a label that is a little limiting I think. It's a kind of an approach, but I think you. And then just [00:29:00] like in, in the realm of pt, you can go myofascial or you can go Mackenzie, Mulligan, OTs do the . You can go more neuro base geriatric base hand base.
[00:29:11] But all those types of techniques are still there. But I really love myofascial. Are you doing something specific to teach more and more new grads and OTs and PTs? In that realm of your style because you can be a hand therapist, but I'm out there teaching people like my style and everything I've put together and my approach to things and my critical thinking of thinking through problems, and I think there's a lot of need for that.
[00:29:39] Absolutely. I'm glad you asked that because I do have a course that's going to be launching soon, within the next few months, and we'll have a separate YouTube channel just for that course. And it's for students, current therapists to learn about the Myofascia release approach. I won't be teaching, the techniques in particular, but it'll be more [00:30:00] about.
[00:30:00] Theory, the science behind it. , what type of population will benefit from it? Some self-care techniques for therapists as well as students. A lot of yummy things that I haven't mentioned are gonna be in there too, but it's gonna be a way to tie in what you already know as physical therapy and make it more honed in on getting a patient the outcome that they really want.
[00:30:22] Yeah. It not as a tool, it's really like, how do we use it for the outcome and. . It really helps in the evaluation sequence and then the plan of care and all the way to the end. Result of, they don't need to rely on you anymore, but they come in for, let's say, a tuneup and we should do that. I love me some tuneups, people who just come in cause they make sure things work well.
[00:30:45] Yeah. You have one help. A whole nother topic, girl, I can get into that, but I know you gotta go. I really appreciate your time and what I'm gonna do is in the description below of this video, I'm gonna include all your info. And I [00:31:00] cannot wait to take your class myself, cuz I wanna know, I wanna learn from you.
[00:31:05] And as soon as you get that out, I will pass it along to all my readership people who are in my program now. So I'm really. I'm so excited and thank you so much for having me on here. I look forward to getting this for us out there for all you guys. Cool. Thanks. All right. Thank you so much. We'll talk soon.
[00:31:24] Thanks.
[00:31:33] Hey, thanks for listening to Hoang's world podcast. If you are brand new to the hand therapy world, head over to my website, www . Hand therapy secrets.com, where you can get started with some of our free guides and paid programs for both OTs and PTs diving into the world of hand therapy. Or if you've been listening for a while watching on our YouTube channel and you think you could benefit from developing and moving your career further along in hand therapy, reach out to me and my [00:32:00] team at info @ Hand therapy.secrets.com and tell us exactly what you're looking for, By the way, if you know someone who could benefit from today's show, please share.
[00:32:10] Thanks. See you on the next episode.
