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Category: Activity Progression

What is the difference between Phase 3: Activity Progression and Phase 4: Exercise, Maintenance, and Monitoring?

Craig Smith February 26, 2024

Welcome to the transition zone—phase 3 to phase 4—at Smith Performance Center. This shift marks an important move from rehabilitation to performance. We’re committed to ensuring that our community doesn’t get stuck in a permanent rehab mindset. The switch from rehab mode to peak performance mode can pose challenges, demanding careful consideration and expert guidance. Phase 3 is all about building up tissue capacity, gradually ramping up activity levels, and prioritizing overall well-being. It involves strengthening muscles, alleviating muscle inhibition, closely monitoring responses to increased activity, and addressing any lingering issues stemming from previous inactivity. Essentially, it’s about improving tissue capacity while laying down a solid foundation for what comes next. In contrast, phase 4 signifies a fresh chapter, with a focus on establishing a consistent exercise routine and raising the bar for performance standards. Our goal here isn’t just to ‘move’ but to instill a long-term commitment to fitness

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Physical Therapy Tucson

The 10 Strategy Mistakes of Repetitive Injury When Exercising

Craig Smith December 14, 2023

Do you want to get back to exercise but keep on getting hurt? The merry-go-round misery of a repeatedly injured exerciser is a common complaint at Smith Performance Center. When someone shows up, our physical therapists listen to a series of injuries that seem to occur every time they get into a workout routine. The exerciser finishes rehab and heads back to their respective sport. The first few days go well, but inevitably the same problem comes back. In our clients’ minds, their body has lost the ability to stay healthy. They believe age is driving the problem, or the joints are shot. They think the activity they choose to do is too vigorous and must be replaced.  These are not the problem.   The cycle of repetitive injury is a strategic mistake. Returning to activity with a strategy We believe in a process called the SPC Phases. A phase at

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The 4 Primary Goals In Strength Training When Struggling With An Injury or Pain

Craig Smith November 7, 2023

Goal setting is one of the most important, yet tricky aspects of training. Our team believes that goals are secondary to developing habits and systems that you can do day in and day out. We call this an exercise habit and it is a critical aspect of becoming an exerciser. However, goals can help to shape your training, increase motivation, and improve decision-making during the course of workouts.  When you are returning from an injury or dealing with a particularly irritating pain, we believe your goal is very specific. You need to exercise without your body feeling terrible. While this sounds obvious, one of the most common training mistakes our coaches see clients make is too much focus on performance while ignoring a recurring injury or pain.  If you have pain during your running, biking, lifting, etc., you will not achieve performance goals. We strongly believe there are 4 goals

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The 5 Most Useful Tools for Progressing Your Workouts After an Injury

Craig Smith September 19, 2023

Too many fail in their effort to progress activity after an injury. You arrive at the gym feeling good but later in the day the low back soreness that has been feeling better comes back or the knee pain that seemed to be going away comes back with a vengeance after your second run.  The regression happened even when the workout felt easy and pain-free at the time. Why is this happening? Why is this phase of rehab frustrating?   It’s due to a fundamental mistake or what we call a violation of the rehab standard, which is training at exercise capacity, not tissue capacity. When individuals make this mistake, they start telling themselves stories like ‘I am getting too old,’ or ‘I guess I need to do something with less impact.’ However, the problem is not due to aging or the fact that the body can return to preinjury levels.

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The 7 Tissues to Consider When Progressing Activity After Physical Therapy

Craig Smith September 18, 2023

The Rehab Standard is an SPC concept that defines when a client has a higher exercise capacity than tissue capacity.   When your tissue capacity is lower than the exercise capacity, the focus of the workout is not how hard you worked out.  It is not how much you sweat or how good of a muscle burn you got. The focus is on the healing tissue and that is was not overloaded, irritated, or provoked.  A violation of the rehab standard can present as pain after the workout or the next day, even if there was no pain during the workout. The key is to focus on tissue capacity in the exercise selection, intensity, volume and the type of tissue injured. We want to look at this last one, the type of tissue injured, in relation to activity progression following an injury. The 7 Tissues to Consider When Progressing Activity Improving

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The 5 Big Problems Facing Clients with Pain and Injury Who Want to Get Back to an Active Lifestyle

Craig Smith September 1, 2023

There are numerous problems facing people in living an active, healthy life, but it can be difficult to articulate the problem that needs to be solved. Let’s look at two people dealing with low back pain. One person bent over this morning to grab a pencil and now cannot stand up straight. The second person developed back pain years ago and stopped doing certain movements because of discomfort. The pain is still present daily and they use a combination of meds, massage, and chiropractic to keep big flares up away. Their problems are different despite both dealing with low back pain. The solutions are very different. The person who just hurt their back needs a diagnosis and a home plan targeting healing strategies and triggers. This may mean more frequent visits and removing anything that makes their symptoms worse. We will likely see this person a few times per week

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The Injury Types That Are Mismanaged During Activity Progression

Craig Smith August 1, 2023

The rehab standard is simple; the limit to your exercise is not how hard you can work out, but rather working as hard as possible without going past your tissue capacity.  Our team sees violation of the rehab standard as the most frequent cause of failure during activity progression. A client will feel great and start to progress their workouts. There is no symptoms during the exercise and often no symptoms the same day, but the next day they feel horrible.  We know that in activity progression, you need to understand the type of tissue that is healing, the specific exercise, and volume. We also need to consider the type of injury: chronic, recurrent, and acute.  Chronic Injury For chronic, we mean is has been present for a long time. When you have a chronic injury or chronic pain, there are two issues: your exercise capacity is lower because it

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The 5 Components of Invisible Triggers That Cause Your Rehab Progress to Stall

Craig Smith June 14, 2023

You keep getting close to feeling good but then fall back into an injury because of a common, but often unrecognized issue – invisible triggers. An invisible trigger is an action or activity that does not seem to be causing your injury to worsen but is actually causing your injury to remain and not heal. If you slammed your finger into a door, you would know the door caused your pain.  Continuing to slam your finger in the door will cause the finger pain to remain. In contrast, an invisible trigger is not as clear as slamming your finger in a door. Patients have an easier time eliminating obvious triggers. This does not happen with invisible triggers. An example would be low back pain triggered by an interaction between two activities: running followed by a bout of sitting. When we investigate running by itself, there is no problem. We repeat

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Four Reasons Why Patient Forms Help Improve Your Care During Your Rehab Process

Craig Smith June 6, 2023

‘Not all relevant outcomes can be assessed with a device, a laboratory test, a physical finding or some other data gathering independent of the patient’s perception and voice.’ -Kroenke, Monahan, and Kean 2016 We want to share with you how filling out patient forms is not only useful to our team but also critical for receiving the best care. In the ranking of where you want to spend your time, completing forms for a medical visit is just above a tooth extraction. The act is mind-numbing. Partially due to the perceived lack of benefit and partially because you know the healthcare provider isn’t using it. They will even ask the same questions that were already answered in the form.  Our team would like to change your mind on this by showing how we use your forms to impact your care – the why, how, and when. There are three clear

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The 6 Functional Exercises Tested During a Movement Assessment

Craig Smith May 2, 2023

A mistake in exercise programming that our team encounters is a heavy emphasis on variety in exercise, instead of movement pattern mastery. Our team does not focus on an endless array of exercises. The focus is on building depth in foundational movement patterns. These patterns make up every movement you perform when lifting. If these foundational movements are missing, advanced exercises will be wasted on poor form. You need to own the basic movements first. During the movement assessment, the 6 foundational movement patterns are assessed with 6 functional exercises from each movement pattern category. The movement assessment is where our strength coaches determine what may cause issues in your program: accountability, rehab standard, location/time, coaching need, and comfort level. The 6 functional exercises help our coaches determine your coaching need, if you have a tissue capacity issue (rehab standard), your comfort level with free weights, and what is the

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