Mastery in Physical Therapy

 Part I: Finding your Life’s Task

A few weeks ago,Don Reagan and his team at Mountain River Physical Therapy (Chatham, VA) made the drive to Durham to speak to the Duke Rehab 2 Performance group. At R2P, we’ve spent most of the summer semester learning the ins and outs of the Selective Functional Movement Assessment (SFMA); many of us first-years only knew Don as “That guy who did an apprenticeship with Gray Cook”, and even more salient for us the day before Clinical Match Day, “He’s a CI for one of the clinical sites we can choose from” (spoiler alert, my lottery number on match day was way too low to snag Mountain River for my third year). We were excited to hear him speak about and demonstrate the SFMA. What he actually ended up talking about inspired me far more than anything anyone else has said to me so far in PT school.


Don outlined for us the concept of Mastery, particularly as it relates to physical therapy. I have since bought and finished the recommended reading (Robert Greene’s Mastery), and my approach to my future career in physical therapy has been completely altered. I’m not sure I completely understand Mastery, but I wanted to write about it – partly because the process of writing helps me to learn and understand, and partly because I hope I can inspire those of you who were not at Don’s talk to at least think differently about WHY you do what you do, and the ways in which you’re doing it.

Mastery basically boils down to SKILL and CREATIVITY. In that order. You cannot be creative if you have not mastered your field, and I’ll talk about that in more detail in a later article.  As Robert Greene says,

“The future belongs to those who learn new skills and combine them in creative ways”

This is what it means to be a Master.  The skills must be learned, and once learned, they can be combined, molded, expanded on. This is how newness is created.


To become a Master, at WHATEVER it is you’re doing, you must pass through three stages: Introspection, Apprenticeship, and the Creative-Active.

The first stage of Mastery is the focus of today’s article. INTROSPECTION. Knowing yourself. And most importantly, knowing what you love. Mastery requires hard work. “Blood, sweat, and tears”, in Don’s words. Malcom Gladwell’s “10,000 hour rule” is another way to look at Mastery – this is about the amount of focused practice and learning it takes to truly master something, be it a musical instrument, an art medium, a sport, a field of science, or – as a physical therapist – getting your patients better.

10,000 hours of blood, sweat and tears. So, whatever it is you are trying to master, you’d better be passionate about it – otherwise, you will succumb to the effort.

Evidence in Motion recently came out with a blog post suggesting that perhaps “following your passion” is not the best path to success. It’s a valid consideration – chasing after what you love is not always going to bring you monetary comfort, or social praise – and the article does make the salient point that WORK, and doing the work RIGHT, is really what matters for success. However, after reading Mastery, I would beg to differ.

How are you going to push through the pain, boredom, frustration, difficulty, how are you going to make the necessary sacrifices if you don’t feel a burning passion for what it is you’re doing?

Answer: You can’t. Even if you manage to grind through something you hate and push out a product, you won’t fool your audience – it will simply be a product, not a work of genius.

“Your emotional commitment to what you are doing will translate directly to your work”.

So….you HAVE to follow your passion! But…how do you even know what that is?

Greene recommends looking back to your childhood for that answer. The lives we tend to lead as adults (or you know, those of us who are still trying to “adult”) often squelch that childlike awe and wonder out of us. It’s hard to really know if we’re passionate about something, or if we just like the attention, money, or leisure time that our work allows us. So, look back to when you were a child. What mesmerized and captivated you? What activities could you not get enough of (besides eating Kraft mac and cheese)? Greene gives the examples of several “masters”, both contemporary and historical, and the moments they discovered their Life Tasks. Mozart, for example, had “that moment” at age four, when he first listened to his older sister play the piano.

I tried this exercise myself. I have not had any major moments of epiphany like Mozart. In fact, most of my childhood was….really not memorable. However, I was able to think of three instances during my younger years when I encountered something that completely enthralled me:

  1. Age 5-ish: Watching an early 80s video of the Mariinsky Ballet performing Tchaikovsky’s “The Nutcracker”.
  2. Age 9: Watching Tara Lipinski and Michelle Kwan battle for gold at the 1998 Nagano Olympics
  3. Ages 6-10: Watching my mom run road races. Marathons, 10-milers, 10ks, etc. .

And two things I did on a regular basis as a child and young adult that really made me feel alive and in my element:

1. Ballet

2.Running (clearly this one stuck!)

What do all these things have in common?

MOVEMENT. The human body being pushed to its limits without breaking. Watch ANY pro athlete in action and it’s just incredible what the body can do. Train for a marathon, or a century ride, or just go play a really intense game of pick-up soccer and you will feel it for yourself. To this day, I am happiest when I’m running, cycling, or hiking. And to this day, I love watching sports – despite the fact that I don’t really have any specific teams that I cheer for.

Combine this with a zest for learning and a keen interest in biology…and it looks like I’m on the right career path.

Another way to do this is to simply make a list of things that light you up. Not “things that make you happy” or “things you like to do” – but things that get you FIRED UP! IN ALL CAPS! Know what I’m saying?

Then, compare that list to the things you actually find yourself doing on a daily basis. How well do they match up? What do you need to do to get those two lists more in sync?

Bottom line: mastering the basic skills of your profession takes 10,000 hours. It’s going to be hard. It’s going to be boring. It’s going to make you cry. Physical therapy education is no exception.  I’ve stayed in to study more Friday nights than I’ve gone out.  I’ve definitely cried more than once (all related to neuroanatomy of course). I’ve skipped meals and hours of sleep….and I’m not even finished with my first year.  Whatever you’re doing, if you want to be GREAT at it the workload HAS to be worth it to you, and for that, you MUST have passion for it.

“Only some INNER DRIVE can help us overcome obstacles, prepare a path, and lift us out of the narrow circle.”

Stay tuned for part 2: Apprenticeship and Skills in Physical Therapy

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