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Author: Craig Smith

Patient experiencing a rehabilitation flare-up with physical therapist support and quote about mastering symptom management

Understanding and Managing Flare-Ups During Rehabilitation

During recovery, there comes a pivotal moment when symptoms improve, and the client feels like they’ve turned a corner. Life feels good again, and naturally, activity levels increase. This change is often unconscious or unintentional—but its consequences can be significant. A rehabilitation flare-up is defined as a return or increase in the original symptoms that led the patient to seek care. The natural reaction to a flare-up is often to question whether the real problem is being addressed. Read: the diagnosis is wrong. But this reaction can lead to a critical misstep—focusing on the wrong issue and missing an opportunity for patient empowerment. Diagnostic Errors vs. Rehabilitation Flare-Up Mismanagement Achieving the correct diagnosis involves identifying potential tissue pain generators, noting local and regional contributors, considering central modulation, and uncovering triggers. This process requires careful collection, analysis, and prediction. And there can be many reasons that diagnosis is hard, but once

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Athletic woman holding her shoulder in discomfort, with a quote emphasizing how exceeding tissue capacity through high exercise demands can lead to recurring injury from exercise.

Tissue Capacity vs. Exercise Capacity: Why Most People Miss the Mark

You’re Doing the Work—So Why Does Your Body Keep Breaking Down? You show up. You put in the effort. Whether it’s running, lifting, group fitness, or weekend hikes, you’re trying to stay active. But despite the commitment, you keep dealing with recurring injury from exercise. Pain shows up, progress stalls, and your body feels more unpredictable than it should. This isn’t about motivation. It’s about biology.The real issue is a mismatch between what you can make yourself do and what your body is built to tolerate. At Smith Performance Center, we call that gap the difference between exercise capacity and tissue capacity the rehab standard—and it’s one of the most overlooked problems in rehab and training. What Is Exercise Capacity? Exercise capacity is your ability to push through effort and accumulate work over time. It’s what most people think of as “fitness.” It includes: Exercise capacity reflects what you’re capable

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Male triathlete running outdoors with overlaid quote emphasizing tissue capacity over training volume, alongside the Smith Performance Center logo.

Triathlon Injury Rehab: How SPC Phases Prevent Setbacks

Recurring injuries derailed Alex’s triathlon training for years—until he adopted a structured, phase-based rehab approach. This case study shows how the Smith Performance Center Phase System helped him move from chronic pain to consistent performance by focusing on what most athletes overlook: building tissue capacity to match training demands.

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A clinician at Smith Performance Center performing manual therapy, assessing elbow range of motion. Hands-on assessment techniques help diagnose movement limitations and guide treatment

Meniscus Tears & Knee Pain: Why Rehab Needs More Than Just Cutting Out the Problem

The Evolution of Thought Around Meniscus Injuries Clinical practice is filled with successes and failures. For some reason, failures tend to linger in memory the longest and often drive the biggest changes in how we approach patient care. A significant moment in my clinical career involved a meniscus tear, knee pain, and the need for surgery. One of the most impactful shifts in my approach to knee pain, particularly in cases involving meniscus tears, came from a repeated clinical pattern: patients improving, then regressing, over and over. This frustrating cycle forced me to rethink my process and align it with a more structured framework—one that incorporates the Smith Performance Center Phases. This helped me answer the question, “Does a meniscus tear require surgery, or can it be successfully rehabbed without going under the knife?” The Traditional View: Meniscus Surgery vs. Rehab For years, meniscus tears were considered a primary cause

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Sean McConnell, a strength coach at Smith Performance Center, works closely with clients transitioning from physical therapy to strength training, ensuring safe and effective movement progression.

Breaking the Injury Doom Loop with Sean McConnell: Why the Right Support System Matters

Confidence is even more important than strength. People come in with doubt and fear of pain. If they don’t believe they can move safely, they won’t move at all. My job is to assess not just their movement, but also their psychological acceptance of movement. The best exercise is the one you can do, so we start small, monitor the response, and slowly build from there

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Alex Griffis, physical therapist, performing knee traction on a patient lying down at Smith Performance Center to improve mobility and reduce pain.

Understanding Vestibular Issues with Alex Griffis, PT, DPT

When it comes to dizziness and balance issues, few areas of physical therapy are as fascinating and misunderstood as vestibular rehabilitation. Dr. Alex Griffis, PT, DPT, sheds light on common conditions like Benign Paroxysmal Positional Vertigo (BPPV) and the surprising role of vision and proprioception in maintaining balance. With techniques like habituation training, he helps patients regain control over their symptoms. If you’ve been struggling with unexplained falls or dizziness, discover how a multi-layered approach at Smith Performance Center can help you regain confidence and improve your quality of life.

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Black and white photo of Kenny Sewall performing an elevated push-up at a gym station in Smith Performance Center, showcasing strength and form.

From Pain to Progress: Building an Exercise Habit After Injury

A perfect time to build the exercise habit occurs when you overcome a painful injury. At Smith Performance Center (SPC), this happens during the “activity progression” phase after stabilizing symptoms. Unlike a standard exercise routine, activity progression focuses on managing and improving tissue capacity—your body’s ability to handle physical load without pain or injury. If these terms sound unfamiliar, don’t worry. The following signs indicate you may have skipped the fundamentals of activity progression: Why Delaying Exercise Is a Mistake Many individuals delay exercise until they feel completely better. However, this approach has drawbacks: Your Path at SPC At SPC, we’ve developed a clear plan to help you build fitness while overcoming an injury. Here’s how it works: 1. Your Home Plan: Manage Symptoms and Flare-Ups The biggest hurdle to starting exercise is handling symptom increases. If daily activities cause large spikes in pain, your exercise plan must be carefully

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Smith Performance Center strength coaches lifting in a gym, demonstrating proper form and technique, emphasizing their expertise in strength training and injury prevention.

Unlocking Your Health Potential: The SPC Phase Concept of Exercise, Maintenance and Monitoring

At Smith Performance Center, you will hear us mention “phases” or see references on the website or social posts.  If this is your first introduction, welcome! The SPC Phase Concept is the cornerstone of our approach. It’s a system designed to solve health challenges, keep you moving, and provide a shared framework for our team to deliver exceptional care. Why the SPC Phases Matter Our mission is to help people stay active, healthy, and capable of enjoying their lives. The five SPC Phases guide you from identifying your problem to progressing toward peak performance. The phases aren’t a one-time journey—they form a cyclical process designed to meet you where you are, adapt to your needs, and keep you moving forward. A key turning point in this system is Phase 4: Exercise, Maintenance, and Monitoring. This phase helps you establish consistency in your health routine while addressing one of the greatest

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A graphic illustrating the relationship between fatigue and fitness, showing how training stress, recovery, and adaptation impact overall performance.

Maximize Your Season: Structuring Endurance & Strength Training with Three Key Questions

Structuring your endurance and strength programming can make or break your training. To help clarify your training schedule, we use three key questions to correctly scaffold the program. While the typical question we hear circles around sport-specific exercises, more important questions often get missed—questions that can make or break the season and influence your performance on race day. Question 1: Are You In-Season or Off-Season? Your immediate reaction might be, “I’m not sure what the difference is.”  To clarify, our strength coach, Spencer, offers this guidance: “If you’re building up to a specific race and tapering to maximize fitness while reducing fatigue, you’re in-season. Out of season might still include races, but it’s not aimed at peak performance.” To put it succinctly, here’s how our team defines it: So, which one are you currently in? Once you know, we can get specific. If You’re In-Season: For athletes training in-season, here’s

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A speaker at Smith Performance Center giving a lecture on exercise barriers and habit formation. The discussion covers evolutionary mismatch, injury risks, shifting barriers, and the gap between knowledge and action in fitness adherence.

The 4 Reasons Exercise is Hard to Start and Maintain

Starting an exercise program usually begins with a detailed look at your goals and a plan to achieve them.  Showing up consistently is assumed. After decades in the health and wellness industry as a personal trainer, strength coach, exercise physiologist, and physical therapist, I’ve seen firsthand that the problem isn’t your goals, program structure, or knowledge of the importance of exercise. You already know regular exercise is crucial. Nor is the problem finding a place to work out, scheduling gym time, or getting the right equipment for home. The real issue is execution: showing up and doing the work.  Exercise is hard to start.  Exercise is hard to maintain. Why? There are four major reasons: Evolutionary Mismatch We did not evolve to exercise; we evolved to conserve calories. Our ancestors developed in an environment with limited access to calories. The body’s ability to conserve energy allowed humans to survive periods

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