A Tale of Two Physical Therapists

Written by:
Tyler Joyce
March 14, 2022

When I was in high school, I read the book A Tale of Two Cities by Charles Dickens. I can’t help but compare that story to my journey as a physical therapist. When I looked over my old cliff notes in preparation for writing today’s blog, Dickens came right out the gate in his first paragraph with the theme of duality. He compares contrasting concepts like hope and despair, light and darkness, and even best and worst. But maybe a good old-fashioned definition of duality may help you understand my point.

The interweb defines duality as an instance of opposition or contrast between two concepts or two aspects of something. As a physical therapist I battle with dualism all of the time. After all, there are two sides to every coin. Most therapists would rather treat someone who presents with a low level of pain versus someone with a high level of pain. They would prefer to work on someone with one injury versus someone with multiple injuries. For this blog, I’m going to focus on how I used to treat patients dealing with high levels of pain and multiple injuries when I first started out in my career, compared to how I think about and treat these patient populations today.

When I became a physical therapist over 20 years ago, I would go as far as sometimes not even doing a movement screen on my patients in fear of aggravating their symptoms. I would start them off with a hot pack and electrical stimulation for 15-20 minutes with hopes of reducing the intensity of their pain before attempting any exercises. FYI, there’s very little evidence that heat and stim actually help with pain, but I did it anyway. Then I would give them pelvic tilts, isometrics and some basic mobility and lumbar stabilization exercises. I would tell them to do these exercises several times per day and that eventually their pain would go away in a few months.

In reality many of those patients barely got any better. To be totally honest, I think the ones that did get better had symptoms that were going to resolve on their own over time. Or they just felt better from taking the medication prescribed by their physician which probably helped more than what I was doing for them.

Keep in mind that I was working in a standard “factory-style” clinic. I had to treat 3-4 people every hour. So there was minimal time for me to assess, treat and educate each person individually. This is actually why so many PTs still use hot packs and other traditional modalities. They’re simply trying to buy themselves time so they can help other patients.

Fast forward to 2009. I joined a cash-based practice called Activcore. Time was now on my side. I could finally give my undivided one-on-one attention to each person individually for 55 minutes at every session. I could also refine my skills as one of the first physical therapists to use the Redcord suspension system. In fact, I began teaching other physical therapists and athletic trainers around the United States how to use this system of ropes, slings and bungees to help them assess and treat their own patients.

Redcord became my secret weapon. The science behind it is called NEURAC (NEURomuscular ACtivation). It applies repetitive “zero-gravity” movements that essentially wake up deactivated stabilizer muscles in order to restore pain-free joint mobility and function. Simply put, it’s like turning on a light switch to the body’s deep stabilizing system that went dim from trauma and pain.

Today, with decades of professional experience and all that I have to offer as the nation’s leading authority in suspension based physical therapy, I can actually make a difference in people’s lives. So now, when those same clients come in with high levels of pain and multiple injuries, my chest instinctively sticks out a bit with confidence that I’m ready and fully equipped to help them. I have ample time to listen attentively to their story. I get to talk about pain science and explain what is happening to their body in the presence of pain. I do a proper examination which includes a total body functional movement screen. Plus I take them through a series of neuromuscular testing in the ropes.

The point of this story is, I never settled for the status quo. I took it upon myself to transform from one type of PT into a totally different one. Hopefully my tale will inspire other physical therapists out there to do the same.

In my next blog article, I will discuss how pain interferes with the healing process and how I apply suspension based physical therapy to overcome this.

Disclaimer:  The views expressed in this article are based on the opinion of the author, unless otherwise noted, and should not be taken as personal medical advice. The information provided is intended to help readers make their own informed health and wellness decisions.

Tyler Joyce

Co-Founder | Physical Therapist
Tyler Joyce is a 20+ year experienced physical therapist who specializes in helping competitive baseball players and weekend athletes overcome chronic pain and injury through application of the Redcord suspension system. He works at Activcore in Princeton, New Jersey, located just 2 miles from Princeton University.


All Blog Posts

How Did We Help Two Professional Sports Teams Become Champions?

Let me start right off by saying that I’m not one to call attention to myself, or to toot my own horn. In fact, I've been known to not even tell my co-workers that it’s my birthday. This should give you an idea of how difficult it is for me to write about one of the best kept secrets in professional sports.


Why Athletes Don't Even Know They Need Neuromuscular Control?

Being injured all of the time is not normal. If you're an athlete, it doesn't necessarily mean you will be frequently injured or in pain. Yes, sports do increase your odds of getting hurt, but they don't guarantee it. In fact, I played basketball and baseball throughout my life and I remember less than a handful of injuries. Of course some of that was simply luck of the draw, but now (as a physical therapist) I realize there's so much more to it.


Why Should Everyone Get Tested in the Ropes?

As a physical therapist, testing has been ingrained in me since PT school. I learned that the initial evaluation process should involve testing of specific parts of the body, such as the joints, muscles, and nerves. The results of these tests would then play a role in guiding my treatments. Basically it gave me a starting point.


Podcast Episode: Tyler Joyce Explains Redcord and the NEURAC treatment approach

In this podcast episode, Dr. Scott Curtis from the Princeton Spine and Joint Center interviewed me about suspension based physical therapy. We discussed the Redcord suspension system that I use on all of my clients. It comes from Norway and consists of ropes, slings and bungee cords. I enjoyed explaining how we use Redcord to deliver the neuromuscular activation (NEURAC) treatment approach...


A Tale of Two Physical Therapists

When I was in high school, I read the book A Tale of Two Cities by Charles Dickens. I can’t help but compare that story to my journey as a physical therapist. When I looked over my old cliff notes in preparation for writing today’s blog, Dickens came right out the gate in his first paragraph with the theme of duality...


Suspension Based Physical Therapy To Overcome Pain

The evidence for treating musculoskeletal pain has remained consistent over the years. It supports two basic aspects of physical therapy: to move your joints and to understand pain science. So why, early on in my career, was it so hard for me to successfully treat patients in pain? I guess moving without pain is harder than you might think. Just ask the old me that didn’t have access to a “zero-gravity” suspension exercise system.


Physical Therapy Doesn’t Have to be Painful!

In my previous blog post I explained the science behind musculoskeletal pain and how Redcord is my secret weapon to overcome it. Today, I’m going to discuss one of the most important aspects of suspension based physical therapy: creating a "zero-gravity" environment so that you can move your joints through pain-free ranges of motion.


There’s A Better Way To Test Your Muscles: Introducing Redcord Testing

I wanted to share something that happened to me while recently evaluating someone for physical therapy. A mother of two elementary school children comes in with complaints of right hip pain and a long history of hammer toes on both feet. Neither of these issues are urgent or in an acute stage. She just wants to prevent them from getting any worse.


Let’s Shake Things Up: The Redcord Stimula

I would like to discuss something that takes suspension based physical therapy to the next level. It’s called the Redcord Stimula. Developed by physiotherapists in Norway, the Stimula is a vibrating mechanical unit that attaches to the suspension ropes in order to provide extra vibration that manual “perturbation” simply cannot match.


The Twelve Tests of Redcord

I wrote this song while sitting in front of my fireplace listening to Bing Crosby’s Twelve Days of Christmas. I recommend getting inspired by listening to Bing’s version first so you can sync my version to his. Happy holidays from the Activcore family to yours.


Anatomy Made Simple: The Myofascial System

If you know me, you know that I love to simplify things especially when it comes to physical therapy. That’s why I love Redcord. It is a simple yet effective tool. Now don’t get me wrong, it looks intimidating with all of those ropes, slings and bungee cords. But once you learn how to use the equipment and understand the testing and clinical reasoning process (known as Redcord NEURAC), it makes treating people so much easier.


Anatomy Made Simple: Inner Muscles vs Outer Muscles

In my last blog post I talked about how to simplify explaining anatomy to clients by way of the myofascial system. Before we dig into each myofascial chain, I would like to discuss another simple concept that has also dramatically improved the way I treat and educate my clients.‍ The concept of inner muscles versus outer muscles was introduced by Anders Bergmark in 1989.


Anatomy Made Simple: The Deep Front Line

In my last two blogs, I explained how our muscles (and hence our bones and joints) are connected to each other through a series of myofascial chains. I also explained how we have inner muscles that stabilize our joints versus outer muscles that move our joints. ‍In the spirit of keeping things simple with regards to explaining the myofascial chains, I am going to break them down from the front of the body, back of the body, and sides of the body.


Anatomy Made Simple: The Front Functional Line

In this blog series, I am breaking down the myofascial chains (chains of muscles that work together to perform movements) into the ones in the front of the body, back of the body, and sides of the body. I highlighted the Deep Front Line in my last post. Today I'm going to talk about the second of three myofascial chains located in the front of the body: the Front Functional Line.


What Have I Learned From Teaching Suspension Based PT?

I am always inspired after teaching any course, and this past weekend was no different. We recently hired 5 new Doctors of Physical Therapy at Activcore and it is my job to teach them how to do suspension based physical therapy. I also mentor them on a one-on-one basis to speed up their learning curve. As one of the first physical therapists in the United States to use this "zero gravity" system, I have countless success (and not so successful) stories to tell.


Anatomy Made Simple: The Superficial Front Line

To be honest, when I talk about the myofascial chains located on the front of the body, I seem to mostly refer to the Deep Front Line and the Front Functional Line. That's because I often find "weak links" along these chains upon testing them, especially in the hip adductors or inner thigh muscles.‍The Superficial Front Line is more of an afterthought, if everything else tests normal.


Treating Low Back Pain: Medication vs Exercise?

Instant gratification is all around us every single day. We get our news immediately from our phones. Our meals come prepared and ready to heat up and eat in several minutes. And we get anything we want from Amazon with literally the click of a button. Our world is moving so fast compared to years ago. So why would recovering from a lower back injury be any different?


How Conventional Physical Therapy Failed a College Baseball Pitcher

I come from a baseball family and more specifically a family of baseball pitchers. My grandfather pitched for the Braves and the Yankees in the 1930’s and 40’s. He stood a lengthy 6 foot 7 inches tall soaking wet. My dad was a 6 foot 5 inch lefty pitcher from Portland, Maine who played one season with the Kansas City A’s. I was a pitcher in high school but an injury to my elbow ended my career before it even began.


What Does a Good Shoulder Treatment Look Like?

There is strong evidence to support suspension based physical therapy for shoulder rehabilitation and performance. So it’s perplexing why it has taken so long to become the gold standard of care. This type of treatment intervention is common in Norway, where it originated. But here in the United States it barely exists. I guess one reason for this is that the profession of physical therapy began in this Nordic region of the world in the early 1800s. Therefore they have about a hundred more years of clinical experience than we do.


How a Snake Bite Helps Explain Pain

I felt inspired to write this blog after re-watching a 2011 TED Talk by Lorimer Moseley on the topic of pain. I have seen this episode multiple times and it always makes me laugh. He knows how to tell a good story that merges science with comedy. He actually makes learning (about pain) fun!