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Category: Treatment

The Modified Low Dye

Craig Smith June 1, 2023

A physical therapy band-aid for foot pain during running Running-related injuries are commonly seen for physical therapy at Smith Performance Center. Unlike some of the advice, you may hear, stopping can prolong the problem.  Rest does not automatically equal recovery or resolution of an injury.  A nice tool to consider learning is the modified low dye.  It can help to reduce foot and lower leg pain while allowing you to continue training. Where is it from? I learned about the modified low dye from Dr. Tom McPoil.  He is faculty at Regis University and was previously faculty at Northern Arizona.  He is an expert on the foot and wrote an article on tissue stress theory that still impacts my practice today.  The purpose of the modified low dye in a physical therapy program is to limit stresses to the tissue of the lower leg and foot to allow desensitization. In

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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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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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Smith Performance Center Tucson

Shoulder Pain Everything Hurts

Craig Smith September 7, 2020

  Why is everything hurting?   “I feel threatened by my shoulder. How can EVERYTHING hurt?” This is an actual quote from a patient with chronic shoulder pain. We see patients who are surprised by how debilitating intense shoulder pain can be.  They struggle to reach for objects overhead, behind them, or to the side.  They struggle with putting on clothes and getting dressed. They struggle with self-care activities like grooming and bathing.  They struggle with seemingly minor household activities: cooking, cleaning, laundry, etc.  They struggle to find a position they can even be comfortable in. Their shoulder pain affects how they sleep.  They start to complain of shoulder pain causing neck pain, upper back pain, or pain down the arm. They cannot work out due to pain. Sometimes, even something like walking causes shoulder pain.  Their activity is drastically constrained. When symptoms are this intense for a prolonged period

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