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What is Aviv Clinics?

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Guest: Aaron Tribby

Release Date: 4/25/2022

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Steve Washuta: Welcome to Trulyfit. Welcome to the Trulyfit podcast where we interview experts in fitness and health to expand our wisdom and wealth. I am your host, Steve Washuta, co-founder of Trulyfit and author of  Fitness Business 101. In today’s episode, I have the pleasure of speaking with Aaron Tribby. Aaron is the head of physical performance at the Aviva clinics in Central Florida.

There’s also another location in Dubai. Aaron is going to explain to us how the Vive clinics golf program fuses with their general larger clinic. Let me break down a little bit what a Vive is about and we’ll obviously unpack this more, but their goal is to deliver highly effective personalized protocol to enhance the performance of the aging brain and body. They do this by using hyperbaric therapies, and a host of other things that Aaron will talk about.

But specifically today we’re really trying to focus on the Gulf performance-related programs. And we’re looking at it both from the client side if I was interested in joining this, what does it look like from the client experience? And actually from a trainer or medical professional experience? You’re the one doing the assessments and the protocols. What does it look like from Aaron side? So it’s a great conversation.

Again, you can find everything about a V that Aviv dash clinics.com. With no further ado, here’s Aaron Tribbey. Of Aviv. Erin, thanks so much for joining the Trulyfit podcast. Why don’t you give the audience and the listeners a little background on you what you do in the health and fitness industry and your credentials?

Aviv Clinics: Hey, Steve, thanks for having me. A pleasure to be on the podcast with you. I’m really excited to talk about, you know what I’m doing and what our team is doing here in Florida, with a Vive so so my role with the company, I am the head of fiscal performance. So I work in manage with physical therapists, exercise physiologists, athletic trainers, dieticians, and out of Vive, our focus is working with clients to improve their cognitive and physical performance through hyperbaric oxygen therapy.

In previous roles, I’ve spent time you know, within health and wellness strength and conditioning, nutrition, some time in sports performance, both in a formal healthcare setting as well as in kind of a private sector, as well, education-wise, an undergraduate in exercise science, and then went and did a graduate school for exercise physiology.

Steve Washuta: Can you give us a little background on a view of and I guess, maybe it’s easiest to start with, like the head macro program, and then we can get into how the belt performance program ties into that?

Aviv Clinics: Sure, you hit it on the head. So the Aviv clinics are hyperbaric oxygen therapy and medical programs. So we work with clients, they come in, and we do a formal three-day deep-dive assessment into everything related to their health span. We go through treatment, which looks like two hours a day, five days a week for three months.

So 12 weeks of time, going through this hyperbaric program, and then we’re going to do analysis on the back end. So really, the tie-in with our golf program was we started to interact and work with clients and have conversations around how their golf game was, you know, they would start making comments as they were halfway through the program about you know, I feel like my focus has improved.

My organization on on each hole is better, I feel like my approaches are better, I’m putting better my drives are more consistent my shot distributions, you know, I’m not spraying the ball as much. And so as we started to kind of hone in on some of these, it wasn’t a single person or event it was it started to just become more consistent and hearing that. And so that’s really where we chose to widen our lens, if you will, and focus in on the golf performance side of it.

We brought into the team, some PGA and LPGA instructors. So as part of the MediCal program, you know, this golf performance side was created. We officially kicked it off and a few months ago back in November. So we’ve only been really operating fully with it for a couple of months now but so far we have couple clients in the program and they’re they’re seeing good changes this far.

Steve Washuta: Does anybody else do this in the country or is this unique to you guys?

Aviv Clinics: You know, there are other companies other organizations as we were talking before that have golf performance programs you know, you go to you get your swing to analyze you know, they give you some cues give you some tips work through it. What sets of vive apart and the Aviv golf performance apart really comes down to two things.

Number one is hyperbaric what we are doing around hyperbaric medicine is like nothing else that the United States has seen today. What we do is we fluctuate the oxygen. So when clients go into the hyperbaric, they’re inside for two hours, we’re increasing the pressure just a little bit to two atmospheres, it kind of feels like you’re in an airplane, so you get a little tightness on the years, we got to equalize a little bit.

But we’re at pressure, and we fluctuate through a mask of 100% Oxygen, that they’re gonna breathe for 20 minutes. Then we remove that for five, and then 20 on five off, and we do that through the whole two-hour session. So why that is different. Really, why it’s important is it causes a couple of things within the body, it causes natural stem cell production. That’s the one that you know, people really hone in focusing on.

But the one that really why I chose to leave my previous roles and come be part of the was because of some of the regenerative processes that we are seeing within the brain and within the body. So that’s really the first is from the hyperbaric the second comes with our multidisciplinary team. So this is a program that’s entirely individualized and tailored to the person and their health. And we’re also focusing on golf during this time as well. So those are really the two things that set Aviv apart from other, you know, golf-related programs.

Steve Washuta: I think the hyperbaric is exciting. It to me, it’s new technology, I don’t know a lot about it. The first time I heard of it was there were football players in the NFL, actually who purchased their own and LeBron James purchased his own and, then obviously, before you know it, you see them on Instagram and it becomes a hit.

Can you speak to concerns people may have? Are there any, rumors about there being issues with the hyperbaric chamber? Are there any negatives to using this at all?

Aviv Clinics: Right? So you know, with everything, there’s contraindications reasons, reasons why you shouldn’t do it. You know the biggest one is something that we call Barrow trauma. And that’s where the pressure starts to increase, we get some pressure on the ears, if we don’t equalize appropriately, you know, that could cause some damage. We have nurses in the dives, we call them dives. terminology is very similar to like scuba diving.

But we have nurses and the hyperbaric sessions with the clients to work on processes to help equalize and to alleviate that, you know, other contraindications, if you will, you know, if somebody is having active seizures, you know, that’s, that’s a reason why we shouldn’t do a hyperbaric if they’ve had a stroke within the last five or six months, you know, those would be some things active cancers.

Steve Washuta: Yeah, yeah. Well, I mean, if you’ve listened to this podcast, my listeners know that. I always say there are no solutions. There are only trade-offs. So of course, if your answer was no, there’s absolutely never any issues with any of this.

I would be skeptical. But it sounds like it is, you know, 99% effective or useful for most of the demographic provided you don’t have a, you know, a certain issue, which is fantastic.

Aviv Clinics: 100%, right. So that is really where our assessment process comes into play. So every single client is going through three days of extensive assessments. And the goal of that, for us is a couple reason, obviously, client safety, you know, that’s the biggest one, are you safe to go into this hyperbaric program? But the second is, it helps us to identify, you know, where’s our starting point? Where are our objective baselines? And then how can our clinicians individualize a program to work with you on every aspect of your health? So I mean, we’re working, you know, if you came into the program, you’re gonna have sessions with a nutritionist to talk about your eating habits.

You’re gonna have sessions with a neuropsychologist to do tailored focus time on your cognition and your cognitive function, you know, time with my team of physical therapists and exercise physiologist to really work on, you know, the strength, the balance, the stability, the mobility side, as it plays into the golf game. And so it’s an all-encompassing approach to your healthspan.

Steve Washuta: I think that’s fantastic. I talked about it a lot, how we need these groups to work together, whether it’s your physician, your personal trainer, your psychologist, your rd, your registered dietitian, and all of these people because obviously, we need to look at health from the sort of a wholesome approach.

And you guys do that there. You sort of already have done this, but can you really walk me through your client experience from start to finish? I come in, I come in, I walk into Aviv, and I say, I want to sign up. How does that process go from start to finish?

Aviv Clinics: So the first touchpoint with every client is a sit-down conversation with one of our physicians. Um, you know, come in, let’s see, put eyes on the facility. But more importantly, let’s get to know you, and what are your goals? You know, what are your expectations as you would enter this program, and then upon completing, but there’s really four phases of the experience, the first is going to be the assessment process, you know, let’s sit down, let’s go through these three days of in-depth testing. And let’s get those outcomes.

The second is going to be the treatment. So going through being in the hyperbaric for two hours a day, five days a week, 12 weeks, but then all of the other sessions with the providers come into play, right.

And then if we’re focused on golf, we’re going to have specific assessments and specific time with golf instructors, because something that we really want wanted to have out of this is a collaboration between the golf instructors, but also the physical performance and the cognitive performance teams. Because when you look at the golf game, if you take a step back, there’s a lot of crossover between, you know, as you know, the physical side of the game, but the mental side of the game.

And we want to see that and work together on the assessments. So that’s really part two, three is going to be the analysis. So once this, the treatment has been completed, let’s take a step back, let’s re-evaluate, and show those objective changes pre and post. And then we’ll have the fourth part being a follow-up. So we invite clients back six to eight months after completing the program to do some ongoing evaluations and objective measurements.

Steve Washuta: Because of your location, I imagine the vast majority of your demographic are seniors is this program specifically catered to seniors? Can anybody join? And if there is a difference between what you do, let’s say, with a younger golfer, in your performance programming a senior Could you expand on that?

Aviv Clinics: Yeah. You know, Steve, everyone, whether it’s somebody that is 70 years old, or you know, guys like us, they’re in their 30s. You know, we can all improve in some way physically or cognitively. And that’s really where our program, you know, touches at. So while we have focused attention on, you know, seniors and their golf and their physical performance and cognitive performance, this program is really for anybody that’s out there wanting to improve cognitively or physically.

Right now, you know, our youngest client is 20 years old, and our oldest client that has gone through the Aviv MediCal program was 90 years old. And then it’s really the individualization you know, so whatever your goals are coming in, everything is tailored to you. So when we talk about golf, right, if you’re a beginner golfer, that’s fine. We’re going to do some assessments to look at your golf swing.

What are those fundamental aspects that we need to implement? And what are those strength flexibility balance exercises that are going to help enhance your game where you’re at today, if you are a professional golfer, right, we may not need to do a whole lot of physical tweaking with your golf swing, because you’ve had all those repetitions, we may really be focusing on the neurocognitive side of your game, and your approaches and what your mindset is, like, as you step foot on, you know, to the tee box, so it can really be tailored to each person at each level?

Steve Washuta: Yeah, as we talked on the front end of this pre-recording here, I worked at a sort of a golf-related Country Club, there were six golf courses on that particular island. So I work with a lot of golfers as a personal trainer, and I will tell you that it’s a very easy pitch for personal trainers to tell these golfers. Listen, you spent 1000s of dollars on your equipment, you spent 1000s of dollars on your golf lessons, you just bought a putter you know yesterday for $400 You’re doing all of these things inside of the game.

But if you’re not focused on your health, you’re not gonna be able to play the game. So it’s to me it’s a really easy pitch to these golfers to go about it to make sure that they’re taking their health seriously and taking both the cognitive side like you talked about, but also the physical side into play, to advance their game but also to extend their lives playing golf now. Now, this is a leading question here. But is it difficult to pitch people on this because it sounds really easy everything you’re saying I want to sign up tomorrow?

Aviv Clinics: So you know I’m a longtime golfer, I started with my dad and brother at an early age and you know continue to play into high school college and today by no means am I amazing, right? But I’ve continued it and I’m guilty of this as well. You know, I’m not driving the ball as I as I might like, oh this will be resolved by going and getting the new driver. When you really break it down. You know our focus is on improving the healthspan.

If we can make some changes and make some improvements in how we’re eating, how we’re exercising, what our stress levels, and how we’re sleeping, all of those different aspects are going to play into how we are performing during our golf rounds. And so that is really, you know, our talking points when you know when I speak with clients, it’s, you know, that is what our focus is that a V, there’s a golf component of it, but our focus is improving healthspan. And then that translates over to how you’re playing day in and day out.

Steve Washuta: What are reasonable results, that one may be able to see from a Vive, whether that’s on, let’s say, the medical side of some sort of the cognitive side, or the Gulf side are their actual, like, some sort of tangible result that you can hope for?

Aviv Clinics: Yeah. So as part of the Aviv golf program, in the MediCal program, what we know today, after 15 years worth of research out of our r&d location in Israel, is that as clients walk out of the program, they are noticing changes in their cognitive performance and their physical performance. So what does that mean for cognitive performance, they’re noticing things like improved attention, better focus, better processing speeds, you know, if they’re an executive, and they’re in meetings, you know, they’re keeping up with the numbers and the financials and the information, memory, we’re noticing big changes and improvements in our memory.

But when we take that and Cross that over to golf, right, if we have better focus and better attention, we’re going to be able to read the green better, we’re going to be able to base our organization on the force, you know, what is our approach like, better hand-eye coordination is going to have better-shot distribution and better contact with the ball. So maybe fewer slices or fades, especially if they’re unintentional.

You know, things like that. When we talk about physical performance, what we’re seeing through the medical side is changes in our cardiovascular and pulmonary functions. So if we’re getting stronger, if we’re improving our endurance and stamina, right, fatigue is not showing up as early, that’s going to allow us to golf at a higher level, put more physical intensity into our rounds. But more importantly, what we’re hearing is better and improved changes in their recovery.

So that’s something that I’ve heard from a number of our clients is, you know, they would only be able to go out and golf, you know, around 18, every few days, because they wake up the next day and have some joint aches and pains and things. And they couldn’t do back-to-back rounds, but that’s their life, you know, they came to this area, they wanted to retire, they wanted to go play every day, and they’re not able to. And so as part of this program, we’re starting to see changes where they can go back and do some of those things that they used to be able to do before.

Steve Washuta: Do you have clients either personally or in the program, who have movement disorders of let’s say, Parkinson’s, because, you know, I worked with a fair amount of Parkinson’s patients and other movement disorders. And I found it there was actually studies done on this by Armstrong Atlantic, which is now Georgia Southern, in conjunction with some other people, but they showed programs not skull specific, but programs like this, that merge the cognitive and the exercise and all this can not necessarily resend any issues due to the Alzheimer’s or excuse me, the movement disorders like Parkinson’s, but it can certainly hold and stave off further, you know, neurons being let’s say, lost and keep that cognitive function going at a high level.

Aviv Clinics: So we know out of the VA on the MediCal program, we work with any client, you know, we have had some clients come through with Parkinsonism, we’ve had clients that have had a traumatic brain injury and stroke, early stages of cognitive decline.

And that’s really where we let the assessment process drive, how we’re going to work with with with the clients because we’re going to be doing images, you know, brain imaging, to look at how is the brain being impacted? What is our current anatomy? carry that over with our cognitive assessments? How is the brain functioning? And is this a program that could make an impact on them? As you said, you know, we are never going to say anything about curing any type of diagnosis.

But something that this program could do is help to reduce some of the symptoms that we’re living with day in and day out.

Steve Washuta: You mentioned some of the I guess you call it equipment for lack of a better term for as far as the imaging is concerned. You talked about the hyperbaric and are there any other pieces of equipment you use either on the Gulf side or the medical side that you find interesting.

Aviv Clinics: So on the Golf side you know we are doing a swing analysis slow-motion cameras, let’s get some swings in, and then let’s really take a step back and together with the golf instructor collaborate on you know, what are they seeing with the golf swing. And then physiologically, what are we also seeing happen, you know, the majority of clients coming in are going to be able to improve from, you know, better flexibility in their hip flexors. Better glute activation, better core engagement.

So, you know, that’s a lot of it. But it’s, Hey, I had a total knee replacement a few years ago, I had some sort of injury in my shoulder. How can we prescribe and build the golf swing around what you are dealing with today? Because it should never be a one size fits. All. Right, everyone has a specific swing. And we can’t always give these very generic tips and tricks around fixing it. Sometimes it needs to be tailored to the person. So that’s one.

We have a gait analysis treadmill. So a high-tech treadmill. Where we can do analysis on how somebody is walking, you know. Is are there a difference in stride lengths, how the feet are rotating? Does that change the faster that we go? Those things are gonna allow us to identify some compensations within the muscle.

And then that’s really where we, you know, our team comes in and approaches. You know, myofascial release soft tissue injuries. Getting stronger imbalances within the muscle. Of improving strength, things like that.

Steve Washuta: So Aaron did a great job describing sort of the client experience. And also sort of the wholesome experience. Between all of the different positions that work in Aviv together in concert. But can you give me a little bit more details? About Aaron’s day? What does the day look like for you at Aviv, what are you doing in the morning, when you first get there, what are you working with clients? I guess, what is sort of your scope of practice there?

Aviv Clinics: Yeah. So previously, you know, I was a 100% Hands-on clinician. So my entire day was working with clients. And then I shifted into leadership, and managerial tasks, for a little while. And when I came to Aviv, I was really excited. Because I was able to get and have a healthy mix of those leadership responsibilities. But also the, you know, the hands-on guidance with the clients. And that was something that I missed for a little while. So what is my day look like? We start every morning with the huddle with all of our providers.

Our physicians, our nurses, our physical performance team, and our neuro-cognitive team are dieticians. And we talk about all of the clients that we’re going to see that day. What our approaches did anything go on the day before that we need to be aware of. So it really allows that good collaboration and communication among all of the disciplines for guiding each person’s programs.

A lot of the morning is going to be working with clients on their strength on their stability. On their balance. You know, working on some different aspects of the golf swing that we identified with the instructors. The afternoons are going to be more meetings, going to the golf course, collaborating with the instructors. Maybe going out and playing around a golf with a client, you know. Trying to keep that engagement in that collaboration with them.

Steve Washuta: I imagine there’s a lot of work done with people either pre or post op. I say that because I work with the senior population. And now that I work with the senior population, I think I should have gotten into hip or knee replacements. That’s where the money is at. Because every other day one of my clients is getting a hip or knee replacement. So what exactly do you guys do on that end? Or do you take on clients who are posting pre op.

Aviv Clinics: So for the most part, when a client steps foot into the program. That 12 week window is really when we are doing the bulk of our training and our guidance with them. Once they’ve completed the program. We are still doing follow-up sessions, building new programs.Updating programs, and modifying things as they come up.

A lot of times, that’s where we can shift to more of a virtual type of setting. Where you know, if someone is from out of state or out of town. Hey, let’s set up a zoom call, you know, every month or every couple of weeks. To do a check-in and see how things are going. But for the most part that 12 weeks is when we’re really doing the in-person guidance and training.

Steve Washuta: So do you have people specifically that would come down there. Or who lived there for part of the year? Take this 12 weeks with you and your team? And then live most of the year somewhere else? But still check-in virtually? And do you check in virtually like this? Or do you have another medium than what you use?

Aaron Tribby: Yeah, so we do have a lot of clients that will come into Central Florida. For the 12-week program from out of town or out of state. We’ve had a number of people fly in from New York, California, and all over the United States for this. And then as you mentioned, right when the program gets done, we’ll do all of our post-assessments. They’ll go home, and then we will have, you know, weekly. Every few weeks every month check ins with them. Just to see how things are going and then build those programs. A lot of times it is tailored to the client.

If they just want to do a phone call, that’s fine, if they want to do text messaging, that’s great. If they want a formal zoom call, that is good as well. You know, there’s a lot of assessments that we can do virtually. Talk clients through having to take a few steps back from the camera and evaluate, you know. Some low-grade muscle compensations. What’s going on and give guidance through that. 

Steve Washuta: you mentioned this earlier, Aaron, but, you know, it just slipped my mind. Can you name all of the positions involved in this. From what exactly you do to you know, the specific medical physicians? Can you just kind of name everyone who’s involved in this process?

Aviv Clinics: Sure. So at the top we have our physicians that are overseeing every client’s full medical program. Clients will also come into contact with nursing teams, or nurses. Dietitians to look at our metabolism, and our eating styles. The neurocognitive team to really look at, you know. How is your brain performance and your cognitive function? What does that mean specifically there to look at processing speed-focused reaction time.

Our physical performance team is assembled of physical therapists, athletic trainers, and exercise physiologists. Those are the majority of the clinicians that we have on-site. And then we have our team that runs the hyperbaric chambers as well. And then our golf instructors, of course,

Steve Washuta: Can you talk a little bit maybe Lastly, because we didn’t touch on this. And maybe some of the listeners don’t know about the area specifically that you’re in? And how that how your golf program works in that area tied into the villages or not?

Aviv Clinics: Yeah, so we are located in Central Florida. About 45 ish minutes north of Orlando. We are in an area that is that has a ton of golf courses. There’s something like 50 Plus golf courses in the area. So very heavy golf pickleball as well.

And that was something when we went our location was established here, you know. My goal is a clinician, yes, we have all these objective assessments right there. We’re looking at clinically, but how can I find something tangible. To kind of connect the dots for any anyone that I’m working with?

You know, if you come in and you say you play tennis? Well, great, what are some of the cognitive changes and physical changes that we are going to see? And how can we point some of those things out in those day-to-day activities. That you’re doing with tennis, or golf, or whatever that may be?

Steve Washuta: And this has been a wealth of great information. Where can the listeners find more about if their general population about the Vive program? Of course, and if there are personal trainers with people in the health side, other clinicians? Can they reach out to you or someone else? To find out more about the actual physical side of the program. And maybe even you know, apply to work there?

Aviv Clinics: Yeah. So my personal email is Aaron a Arwin. At a Vive, a v i v dash clinics.com. You can visit our website at a v dash clinics.com We have a Facebook page and Instagram account as well. If you’re just interested in getting more information and just want to pick up the phone. You know, our phone number is area code 352-488-2848.

And the first session that every client has is sitting down with one of our physicians. To talk about, you know, deeper dive into the hyperbaric program. What are your goals with this and what could we expect to see upon completion of the program? And that’s a complimentary free session that can be either in person or via zoom.

Steve Washuta: My guest today has been a viz Aaron Tribby. Aaron, thank you so much for joining us for the podcast. 

Aviv Clinics: Thanks Steve, a pleasure to be on.

Steve Washuta: Thanks for joining us on the Trulyfit podcast. Please subscribe, rate, and review on your listening platform. Feel free to email us as we’d love to hear from you.

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Thanks again

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