POCATELLO — By specializing in rehabilitating athletes, staying up to date on research and technology, getting to know clients well and helping people who are uninsured or under-insured, Streamline Sports Physical Therapy has set itself apart in the Gate City.

Blaire Zikratch-Clayson, an Idaho State University graduate and Pocatello native, started her clinic in October 2016. Soon after, she realized the space she was in was too small for her growing business, and in November 2018 the clinic moved into its current location at 335 E. Lewis St., Suite 10, in Pocatello. The building is owned by Zikratch-Clayson’s father, Tim Zikratch, who has operated the custom furniture business In The Woods out of that building for the last 42 years.

Soon, Streamline outgrew its allotted space in the building and expanded into In The Woods even more in March 2019. The clinic now has about 20 employees and is 4,000 square feet — a big increase from the about 1,000 square feet it had at the original location.

“I want to give him credit because he sacrificed a lot for me to be in this place,” Zikratch-Clayson said about her father. “He had to downsize big time so that I could do this.”

Zikratch had to get rid of his showroom in order for his daughter to move in, but he said that was a price he was happy to pay.

“Her thing was my vision,” he said. “When she first started this profession, I said, ‘Hey, I’ve got the building for you.’ I can’t think of a better thing to do with my building.”

PASSION FOR ATHLETICS

Athletics is a passion of Zikratch-Clayson’s, and while her clinic sees patients of all kinds, she specializes in getting athletes back to their sports without injuring themselves again.

“There are a lot of issues with athletes going back and maybe not being ready and hurting themselves,” said Zikratch-Clayson, who has a doctorate in physical therapy and a master’s degree in athletic training from ISU. “Clear back in 2012, I started a return-to-sport testing protocol with Dr. (Kenneth) Newhouse, who’s an orthopedic surgeon in town. That became my niche and general orthopedics as well.”

Zikratch-Clayson works closely with the Athletic Department at ISU — a relationship that developed over many hours of volunteer work.

“Within athletics, athletic trainers, at least collegiately, really are the gatekeepers there,” she said. “They have a lot of say in who goes where and who they work with and that kind of a thing because they are the athletes’ first line of care. So I spent a lot of time developing a relationship with the head trainer at that time — just countless hours — and ... starting to work with athletes there, and then when I moved (to the new clinic), they stayed with me.”

To help with getting athletes back to their best form, Zikratch-Clayson has invested in some high-tech equipment. There is a high-performance treadmill and a $50,000 Biodex machine that measures muscle strength.

The Biodex machine is used for “strength, power and endurance testing, and it will give me actual percentages compared to their good leg,” Zikratch-Clayson said. “… It’s big for testing, but it’s also big for training because there’s no better way. It can do concentric and eccentric, so muscle lengthening and muscle shortening. Eccentrics are really hard to reproduce in a lot of situations but are the gold standard for strengthening.”

Zikratch-Clayson said her clinic’s techniques are unique in Southeast Idaho. She and her employees focus on the big picture instead of just the basics.

“A big part of it is not only just the basics — getting your range of motion, your strength, getting all that stuff back — but making sure that we look at the whole thing so that the problem actually gets resolved, insofar as is possible anyway,” she said. “We have a lot of open space, which a lot of places don’t have, because we spend a lot of time working on how people move, and we’ve developed some ways of doing that over the years that are pretty effective and pretty unique.”

In the past several years and after a lot of research, Zikratch-Clayson has developed a return-to-sport testing protocol. In 2012, Dr. Newhouse with was frustrated with the amount of athletes who were reinjuring themselves after rehab and urged her to look into developing a new program to help prevent that.

“I ended up doing a ton of research and seeing some testing that people were doing but more realizing that there was a quality of movement component to it that was totally being missed when we were just looking at strength,” Zikratch-Clayson said.

She said the testing protocol she created is more objective than what they were using before and it has been highly successful, with only a small handful of athletes reinjuring themselves.

“There’s a very big difference between rehabbing an athlete and releasing them back to sport and knowing how to close the gap between rehab and playing surface,” Zikratch-Clayson said. “... I’ve been successful with athletes over the years I think because I spend so much time dissecting exactly what it is that they need to do.”

HAPPY CLIENTS

When Zikratch-Clayson started her business, she wanted it to be profitable, but she also wanted to make sure that her clients felt cared for.

“In any business, you’re limited by time, you’ve got to pump them out, because there is a bottom line,” she said. “So a goal of mine was to find a way to do both: to be profitable enough for a business and to make it worth it, because I’ve had to put in a lot of time to do this, but also to maintain one-on-one quality.”

Zikratch-Clayson wanted to move away from a “time is everything” attitude and more toward a business model that allows for both profit and care because, she said, people get better faster when they feel like the person they’re working with is invested in them. As a result, she gives each client more time and has hired enough people to make sure she’s not packing clients in.

“There’s a decent amount of profit to be made in any health care anything. I feel like a lot of places just get kind of greedy,” Zikratch-Clayson said. “So maybe I’m not concerned with this massive profit margin, maximizing it as much as possible, as I am making sure that patients are happy. We book in 40-minute appointments. Nobody is ever here for just 40 minutes unless they absolutely need to go.”

Zikratch-Clayson takes the time to get to know each of her clients and their individual needs by carefully listening to what they tell her.

“I’ve talked to a lot of people who go places and then end up here, and we go, ‘What worked and what didn’t? What do you feel was good and why are you switching?’” she said. “And the comment that I hear the most is just not necessarily feeling like they were getting that one-on-one and real interest in what’s going on.”

While Zikratch-Clayson and her employees are sensitive to people’s feelings and needs, generally speaking, she said, everyone — both clients and employees — has a good time in the clinic.

“Everybody has fun,” she said. “It’s open. We joke about a lot of stuff. People enjoy coming. They work their butts off, and they’re amazed that (physical therapy) can be that hard, but generally speaking everybody has a good time.”

Zikratch-Clayson spends a lot of time training employees to catch them up on her expertise. That being said, she wants each employee to approach things in their own way.

“I invest a lot into training employees because over the years have developed a lot of ways of doing things that are a little bit more involved, a little bit more efficient, a little bit more unique than a lot of the standard things in physical therapy,” she said. “I wanted to build my business based off of those things that have been very successful with people. So I invest a lot of time and money and energy into really training a lot of my staff. I want to take your experience and I don’t want anything to be cookie cutter. I don’t want to tell you exactly how to do things, but I want to make sure that you have all of the detail and the quality and the knowledge and the stuff that I have gained on top of whatever else you do.”

Hiring the right people was important for Zikratch-Clayson — partially to make sure clients are properly cared for and partially so that she can eventually take a step back.

“Eventually I want to not have to be here all the time in order for the place to survive,” she said. “That meant that I would have to find people to reproduce my skill in so that the skill was still here even when I was gone. In order for that to happen, you have to have enough (physical therapists) so that the absence of one doesn’t just tank the place."

Another thing that was important to Zikratch-Clayson was providing an opportunity for people who were uninsured or under-insured to get the help they needed at a price that wouldn’t break the bank. If a client pays cash, physical therapy visits are usually about $150, and “who can afford that?” she said.

She ended up developing what the clinic calls wellness programs. Clients pay one monthly price and can come in an unlimited number of times during that month.

There are three wellness programs:

Exercise Wellness: For $100 per month, clients get an evaluation, a skilled exercise prescription and one-on-one exercise coaching and progression.Modalities Wellness: For $200 per month, clients get everything in the Exercise Wellness, plus use of recovery and healing modalities such as dry needling, cupping and recovery boots.Manual Wellness: For $300 per month, clients get everything included in the previous two plans plus manual therapy from a skilled clinician.

It seems like her clients are happy with the business model. Zikratch-Clayson won No. 2 in the Idaho State Journal’s 2019 Reader’s Choice awards in the physical therapist category, and she won a 20 Under 40 award in 2018.

As for the future, Zikratch-Clayson said she wants Streamline to stay on its current path.

“My goal as a business is not to continue getting huge,” she said. “My goal has always been to have it be big enough that it was stable and self-sustaining because I, like most people, want a decent work-life balance.”

For more information, visit streamlinesportsphysicaltherapy.com.