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Author: Craig Smith

The 5 Patient Responses That Should Impact Your Physical Therapist’s Strategy

Craig Smith April 5, 2023

In a session, the first rule as a practitioner is to make sure we do not lie to ourselves about what’s happening, and lying to ourselves is the easiest thing to do. We can lie to ourselves when we make errors in reasoning due to a plethora of cognitive pitfalls like confirmation or optimism bias, overconfidence, or mistaken availability heuristics. This can ruin the chances of a great outcome if I only search for facts that confirm my dominant theory, or if I want the patient to have a great response so I ignore portions of the medical history that would lead me to a think of worse prognosis. These cognitive errors ‘help’ me to lie to myself. One solution is to get very clear on what the patient is reporting. There are only 5 patient responses in the session: great, good, bad, terrible, and no response. Certain pathologies readily

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4 Ways Individuals With Heel Pain Can Make Their Pain Go Away

Craig Smith January 31, 2023

Why is your heel pain not getting better? Heel pain is a common, painful foot condition leading internet searches for “cures to heel pain” or “treatments for plantar fasciitis.” The pain resolves with time if the cause of symptoms is removed, but up to 10% of individuals with heel pain do not get better. These chronic sufferers try everything to get rid of the pain including plantar fascia releases, injections, and pain medications. The causes of heel pain are numerous, ranging from plantar tendinopathies like the flexor digitorum brevis, nerve involvement with tarsal tunnel syndromes or lateral plantar nerve, low back referrals, and double crush syndrome to fat pad injuries. The answer is not more stretching and new orthotics. If you are stuck with heel pain and the typical treatment for plantar fasciitis is not making you feel better, then you likely have a different problem and require a different

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5 Treatment Options to Reduce Knee Pain without Surgery, Injections, or Drugs

Craig Smith January 30, 2023

We treat intractable knee pain on a daily basis. Our process is called the PT Solutions Treatment Hierarchy. The treatment hierarchy allows our team to support the diagnosis, reduce pain, and create a clear home plan. Building a treatment framework is a critical component of the plan and it changes based on the key sign, the structural diagnosis, and the trigger management plan.  For example, a person with an anterior horn meniscus lesion, we would first normalize painful end range extension of the knee.  Once passive extension is pain free, we would start to load their leg with the activity that normally hurts, providing them an exercise like terminal knee extension with the band that will keep their knee extension pain free.  Finally we would dig through all of their daily activities that cause symptoms like fast walking or going downhill and stop them from doing it to allow healing.

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Injury screening process explained

The Dynamic Recursive Model of Long Term Development: A key principle in our strength training and physical therapy methodology

Craig Smith September 24, 2022

Why Do We Focus on Long-Term Development in Strength Training? Activity brings benefits and risks. Every step, competition, or practice is an exposure that impacts the body. The questions – how do I get better and how do I stay healthy – are part of a dynamic and constantly changing system (Figure 1). We can model that system to show how the activity, like running or playing football, impacts your next exposure. The Basics If you are a runner, you need to run. If you want to get stronger, you need to lift. If you want to be a great triathlete, you need to swim, bike, and run. If you want to shoot well during a basketball game, you have to shoot over and over. ​ You get the picture (maybe).  There are no prodigies (Ericsson 2004). Reaching your potential requires effort and time. However the very activity you participate

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7 Signs Your Heel Pain Is Not Coming From Your Plantar Fascia

Craig Smith January 31, 2022

Seven Signs the Flexor Digitorum Brevis is causing your heel pain NOT the Plantar Fascia You wake up, swing your legs to the edge of the bed, and…hesitate. You know this is going to hurt. The good foot moves to the ground first – you learned from that mistake over a month ago.  You brace and put down the other foot, the ungrateful one that will not get better despite the trip to the podiatrist, the injection, physical therapy, the shoe inserts, the ice bottle massage, and the stretching exercises. The foot touches down.   It’s not so bad, you think ‘those stretches and night socks are helping!’ Then you step and the sharp pain feels as if the tissue from the back of the heel is ripping apart. You think to yourself, this plantar fasciitis won’t go away, as you force your leg forward and take the next step and the next

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5 Rehab Mistakes and How to Solve Them

Craig Smith December 5, 2020

The majority of our patients have been treated somewhere else first without improvement. When we review their case, similar process mistakes happen over and over again. Lack of diagnosis (Mistake #1) or telling a patient to just stop the activity that hurts (Mistake #4) leads to more problems and eventually to a life of inactivity. Our passion as a company is to keep moving for a lifetime and the number one reason people stop or don’t even start an active lifestyle is pain and injury. Understanding these common mistakes can help you become a better consumer of rehab services and get better faster with longer-lasting results. The end result is the ability to do the day you want. The 5 rehab mistakes and their solutions The mistakes below are strategic errors: Mistake #1: Not Defining The Problem And Possible Problems Causing Pain Mistake #2: Confusing a Single Treatment as the Solution Mistake

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Linear Periodization

The Principle of Progression in Strength Training

Craig Smith October 10, 2020

Milo of Croton, a wrestling, bull-carrying, 20 pounds of meat-eating, 10 liters of wine-drinking man from Greece, is the definition of progression. Most people know the story of Milo, even if they don’t know his name. Milo carried a bull around on his shoulders. Chuze and LA Fitness were not around in ancient Greece so the Greeks created their own strength training methods. Milo intuited the importance of planned, progressive training. As a boy, he picked up a young calf and carried it around on his shoulders (because, why not?). The next day, he carried the calf again, and again the next day, and the next, and continued for FOUR years. The calf grew into a massive bull; Milo grew as well (#gainz). The daily training allowed Milo to pick up a full-grown bull, a mythical feat of strength. Our point? Progressive training regimens produce benefits that are hard to

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Craig Smith

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