Category: Pathology

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

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

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

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 Steps To Develop A Diagnosis In Physical Therapy

“My butt hurts.” A significant proportion of my conversations start with this statement. She continued, “ I have regular active release along with dry needling. I stretch my hamstring ALL THE TIME and I still have pain.” Her frustration was palpable. “I know I have a tight hamstring and there is scar tissue.  But it’s been 8 months.” She assumes the pain must be the hamstring; we call this the pain generator.  The hamstring tendon attaches right where her pain starts. The tightness is over the hamstring muscle belly.  She describes the pain in a clear way that implicates the hamstring.   She made a convincing argument that the hamstring is the issue and the diagnosis has been repeated by multiple medical providers including a physician and two physical therapists. The location matched.  Running increased the pain. Another match. Stretching and manual therapy provided temporary relief. But 8 months into the

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Smith Performance Center Tucson

Knee Pain Meniscus Degeneration and Clinical Experience

  How do you manage knee pain with a meniscus tear?   Meniscectomy, sham surgery, and clinical experience avoiding surgery for pain and function Clinical practice is filled with successes and failures. For some reason, the failures are the thing you remember most and for me, lead to the biggest changes in practice.  The patient that never feels better will never quite leave your mind even when you go home from work.  Knee pain and Meniscus Tear – Round 1 Since my main interest has always been the lower extremity, specifically the foot, ankle, and knee pathomechanics and pathology, I wanted to be the best at rehabbing these injuries right off the bat. My failure with a patient suffering from chronic knee pain led me to the literature surrounding meniscal surgery. The patient reported sharp pain with occasionally catching in the knee joint. The joint had mild joint effusion and

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Knee Pain and Physical Therapy

Knee pain is a big issue with numerous treatments to consider. We believe that physical therapy is a great way to resolve your knee pain, but not all physical therapists treat the same way. Our team suggests that patients with knee pain consider the following: make sure you get a diagnosis, understand your prognosis, develop a treatment plan, and understand the triggers occurring in your day to day. Why isn’t your knee pain going away? You may not remember when you started thinking you had bad knees, but at this point, you start to have an internal debate with yourself about standing up.   Do I really need to go to the bathroom or should I wait? Or maybe for you, you decided to bike now because running hurts. Or you may be waiting to get a total knee arthroplasty because a surgeon told you were too young to have a

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Smith Performance Center Tucson

Imaging & Pain

In the clinic, we get a lot of questions about pain because it is the main reason people walk through the door.  Today I am going to go through a brief review of pain and imaging. Imaging refers to radiographs (x-rays), MRIs, and CT scans. These are typically used to help a medical provider determine what is causing the pain and the best intervention to resolve the problem.   What do we know?  Numerous imaging studies ranging from the knee to the low back show that the level of pathology cannot predict a person’s pain experience.  We cannot predict pain, the level of disability, or long-term activity based on an image.  Individuals with chronic low back pain have been compared to those with no back pain.  The findings on the imaging do not show consistent differences between these two samples.  For example, a woman with nasty, limiting pain may show

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Craig Smith

Craig Smith

BUSINESS Craig Smith is the co-owner of Smith Performance Center. He founded SPC with Sarah Smith in 2015 with a mission to provide the Tucson community with the support and tools to manage their health and stay active for life. He is a partner with Evolve Flagstaff. Founded in 2017, Evolve brings together gym, physical therapy, nutrition, and meal preparation services to support the Flagstaff community. Craig Smith founded Amptimum with Ryan Seltzer in 2020. Their mission is to unleash the clinical skill set of allied health professionals by developing documentation mastery, patient management processes, and robust analytics. WORK As a physical therapist, Craig is interested in physical therapy concepts with clinical application, PT diagnostic methodology, innovative healthcare solutions, and team-based practice. He specializes in lower extremity care, gait analysis, and physical therapy. As clinical director, Craig works to develop a shared framework for his physical therapy and coaching team. The shared framework, called PT Solutions and the HHP Program, is carried out daily with hundreds of patients and members. As a consultant, Craig works with allied health professionals to understand their clinical processes. This focus allows for clinicians to optimize their operations and to improve their clinical outcomes, train new staff, and reduce the burden of practice. AWARDS Craig graduated from NAU with distinction and was awarded the Distinguished Graduate for the Department. He graduated with honors from the University of Nebraska at Kearney and was awarded the Outstanding Major of the Year in Exercise Science by NAHPERD. Most recently, he was awarded the Excellence in Achievement from Northern Arizona by the NAU Alumni Association in 2020. RESEARCH Craig has presented research at the American Society of Biomechanics National Conference, the American College of Sports Medicine Annual Meeting, and the National NEXT conference along with numerous local and regional meetings on topics surrounding injury screening and prevention. He has publications in the Journal of Strength and Conditioning Research, Journal of Athletic Training, Journal of Orthopedic and Sports Physical Therapy, Medicine and Science in Sports and Exercise, Journal of Sports Medicine, and Lower Extremity Review. Craig and his colleagues, Dr. Warren and Dr. Chimera, were selected as one of the “Best Clinic Case/Research Submissions” at the 60th Annual Meeting and 4th World Congress on Exercise is Medicine of the American College of Sports Medicine.
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