Dr. Rori Alter is a Doctor of Physical Therapy, Strength and Nutrition Coach, and Competitive Powerlifter. Dr. Rori is the founder of Progressive Rehab & Strength, LLC., providing rehabilitation, coaching, programming and nutrition services for competitive and recreation strength athletes. Her training, knowledge, and experience enable her to play a unique role in the lives of her clients. She not only understands how to customize and adjust programming to give her clients the best results, but also diagnoses and treats injuries, and helps clients adjust movement patterns and programming to train injury-free. Rori is a Full-Body Certified Active Release Techniques Practitioner, a Starting Strength Certified Coach, and a sought-after Physical Therapist and Strength Coach within the powerlifting community. She is a nationally ranked Powerlifter having placed 1st in the Arnold Classic Sling-Shot Pro American 2017 (72kg Women Open), 4th in the USA Powerlifting Raw National Championship 2016 &, 2017 (72kg Women Open), and will be representing the USA for Bench Press at the International Powerlifting Federation's World Bench Press Championship in 2018.
How have you evolved as a Physical Therapist and strength coach over the years as you have gotten older and wiser? What changes have you made over the years regarding how you treat your patients, in particular powerlifters?
I really love getting this question and I think it is something important to discuss so both powerlifters and newer physical therapists and student physical therapists have a glimmer of hope when entering the field. The most important things as it relates to both coaching and being a great clinician include being open minded and flexible as well as keeping up with the ever-changing evidence related to exercise science and rehabilitation. When I first started lifting, coaching, and practicing as a physical therapist in 2012 I was inflexibly subscribed to certain schools of thought. For example, I followed the Starting Strength Model to the T, I believe Active Release Techniques was one of the only ways to get results with soft tissue pain, and I placed a strong emphasis on biological factors associated with pain and injury. While you can be successful subscribing to one school of thought and have a very dogmatic, "my way or the highway" approach, it will not serve you the best in the long run.
Over the years, through personal experience as a lifter, working with different coaches, being riddled with injuries in my early powerlifting career, and failing more times than I want to admit as a business owner, coach, lifter, and physical therapist I've learned some very important lessons that have influenced the way I work with my clients:
- There is no ONE perfect way
- Everyone is unique therefore nothing is cookie cutter
- Keep things simple for as long as possible so you have room to grow
- Be flexible and evolve with yourself, your clients, and the changing evidence
You spend quite a bit of time discussing the important topic of “the failure to achieve end range hip extension.” Please discuss this topic further. What do you mean by this and how can those reading this article begin to achieve the end range hip extension you believe is so critical?
This "failure to achieve end range hip extension" is in reference to staying flexed at the hip at lock out in the squat, and to some degree in the deadlift. I would say it is MORE of a problem in the squat than in the deadlift and it can have a couple of ramifications. Firstly, since we are all likely powerlifters here, a requirement of the competition squat is that you lock out your hips. Therefore, if you leave your butt back behind the bar and your knees, you may not get the rack command. Secondly, we are likely all lifting to get as strong as possible so if you are not locking your hips then you are not strengthening your glutes and hamstrings through the full range of motion. Thirdly, locking out or "stacking your joints" momentarily provides rest for the muscles and tendons reducing time under tension for the hip and low back. Often when people come to me this is a common reason they have back or hip pain and the simple fix of achieving full extension gets rid of it! Lastly, the hips staying flexed is often associated with the knees staying flexed and all of the above points apply to the knee joints and muscles as well.
For those reading this who might be thinking about pursuing a degree in Physical Therapy, what advice would you give them? Further, what is your opinion on how Physical Therapy is taught in the academic setting? What do the universities need to do different to move physical medicine and rehabilitation in the right direction?
You have to go to school to get the degree and to get the license. It will take MANY years for the licensing exam to catch up to current evidence and practice AND sports/orthopedic physical therapy is only one small subset of a very vast field (pediatrics, oncology, neuro, women's health, etc.) so you may not always agree with or care about what you are learning in school. Stay humble and respectful to the professors, be open minded, get your degree, and get your license. School focuses on teaching you the basic necessities to be an entry level clinician and keep your patients safe. It is then up to you to take continuing education courses and keep up to date with the research to become the clinician that you want to become and/or specialize. For our education system to move forward we need new, younger clinicians to become educators. If you want to see the field change, become that educator.
Let us talk about PRS: Progressive Rehab & Strength, your very own company. What inspired you to take this giant step and create PRS? What makes PRS unique, what makes PRS different and what is your overarching goal with PRS?
I knew from the time I was 19 that I wanted an integrative wellness company and started to pursue a career in physical therapy. I have always had the desire to own a business. After graduating from college, I worked in environments where I was overutilized, underappreciated, that were male dominated, and even experienced bullying in varying degrees in every workspace. I started my side hustle with nutrition and powerlifting coaching because we did not offer that where I worked and there was a need for it. That grew and grew until it was bursting at its seams and I could no longer work two full time jobs. The goal was always to leave and start my own business so in 2015 I did just that! I have done a few podcasts on my business journey so if this is something that interests you, check them out here!
PRS is unique because our standards are very high and the quality at which we provide services is as well. All of the coaches at PRS are not only physical therapists but competitive, experienced lifters as well. On the client end, we focus on integrating barbell training into the rehabilitation process and we strongly emphasize an injury risk reduction and longevity-based approach with our barbell coaching athletes which is demonstrated in our very low injury rate and retention. We not only work with clients locally but all over the world which has given us a unique opportunity to help more people than we could ever imagine.
We also aim to continue to grow our clinical network to bring in more clinical coaches and as such, have courses designed to lead to the PRS Clinical Coach Credential. Our courses cover programming, technique, injury risk reduction and rehabilitation as well as our business best practices. This is how we aim to ensure that all clinical coaches who are in the PRS network provide the same quality of care, have the same treatment and coaching practices, as well as the same ethical practices. Quality over quantity is the name of the game.
There are quite a few coaches who discuss the importance of “symmetry” and how being asymmetric is a recipe for disaster? What are your thoughts on this? Is this a myth? Is there some truth to this? How should lifters think about symmetry and asymmetry?
I think this belief is an absolute fallacy. We are not symmetric by nature and when being evaluated and diagnosed for a new type of pain or injury it is very unlikely that the asymmetry is new as well. It is likely been there most of your life and it is NOT the asymmetry that is leading to the experience of the injury. We must be objective and step outside the body to figure out what CHANGED around the time of the injury. Injuries are most often related to a CHANGE in volume, intensity, frequency, technique, or recovery practices in lifting or life. Maybe you changed your work schedule, picked up an extra shift, got a new belt, or a new car, added an extra day of lifting or conditioning, lost form in your training session, etc. That is what needs to be addressed and managed rather than the asymmetry. You can treat the tissue but if you don't address the root cause you'll never really get rid of the symptoms.
I'd recommend reading this article and checking out these two posts (post 1, post 2) to put your mind at ease regarding having some type of asymmetry, large or small. They can 100% be symptom and problem free if managed appropriately.
What is the most underutilized exercise in the gym that you think should be a “must” for any powerlifting/strength program and why? What exercise doesn’t get the love it deserves.
The Overhead Press!! I have so much content on this, so I'll leave it all below for you. Read it, learn it, love it, use it!
On meet day, take us through your mental checkpoint? For lifters who struggle with anxiety, self-doubt or other mental components of the sport, what advice would you give them?
HAVE FUN! Remember why you started. We all started lifting to better ourselves physically, but if we begin to lose the fun of the sport, we are not going to stay motivated and keep performing. Even at the highest level of competition I focus on having fun and beating ME and no one else. When I have lost sight of that in the past, I have had poor performance.
You made quite an interesting post a while back, discussing that perhaps an individual’s back pain is in-fact being caused by their belt. I found this very interesting and wanted to explore it further with you. Why might the belt be the cause of a lifters back pain. What checklist (for lack of a better term) should lifters go through when it comes to selecting a belt? When it comes to selecting a belt, where do most lifters go wrong?
I think this may be the post you're talking about.
Oftentimes what I see happen is that people breathe, position themselves and move one way and then change all of that when they put the belt on. The other thing I see is an improperly fitted belt or the belt being too loose! Here are some things to remember:
- Your technique and breathing should NOT change when you put the belt on. The belt AIDS in you doing what you're already doing better. You really don't need to do anything differently with the belt on.
- If the belt is too loose or too big for you it can get in the way of you achieving your optimal positioning and/or the position you warm up with when you're not wearing it. Our working sets should not change in technique and therefore, our belts should not cause our technique to change either.
I would recommend checking out THIS post for details on how to find the right belt for your body so it fits appropriately and assists your rather than impedes you!
Let us talk about the bench-press. In your opinion, what is the biggest flaw you see lifters making when it comes to executing the bench-press properly? Further, for lifters who struggle with leg drive during the bench press, what advice would you provide them?
Ooof there are so many! Some flaws:
- Following the bar with their eyes. This leads to an inconsistent bar path.
- Trying to achieve a "J-curve." This leads to wasted energy. The bar path should be a straight diagonal path from the breast to over the shoulder joint.
- Tuck and flare of the elbows. The elbows should be in line with the bar the whole time. Again, wasted energy and risk for injury with motion that does not contribute to the direct motion of the bar up.
- Not setting their shoulders and getting tight.
- Only implementing leg drive off the chest rather than the whole time.
I have got a 3-part series that dives deeply into the points above. 3 Reasons Your Bench Hasn't Progressed & It's Not Your Programming:
Also check out my bench press tutorial on YouTube! And more recently, I did a Facebook Live for the Starting Strength community and they turned the 1 hour live into a YouTube video. It's called Common Bench Press Errors & Fixes!
What is your favorite quote and why?
"No one is perfect and if they say they are they are lying." This is my quote and I truly believe this to be true. With social media and all the highlight reels we see every day, we can be very hard on ourselves. If we expect perfectionism all the time, we set ourselves up for failure.
When your time on this earth comes to an end. How do you want others to remember you?
As a genuine badass who simply cares about helping people achieve their best selves. As a quality over quantity type of person and a gal who just wants to help people :)