diagnosis Archives - Smith Performance Center

The 7 Home Plan Mistakes Ruining Your Progress in Physical Therapy

Craig Smith November 27, 2023

Not all home plans are made the same. Home plans are therapeutic exercise lists that undergird your journey in physical therapy. Unfortunately, home plans can stall your progress. This happens for a variety of reasons – the home plan becomes an afterthought to your care, the physical therapist is overloaded with clients, the overuse of assistants, or too much of an emphasis on what is done to you by the practitioner versus what you can learn to do yourself. We see each of these situations when reviewing the histories of new clients with long-term injuries. The home plan is a critical component of your rehab plan in physical therapy. Our team regularly helps new clients who have been doing the same home plan from physical therapy for years which is not helping. This includes obvious mistakes like stretching an irritated nerve, overloading a painful joint with weight-bearing exercise, or making

5 Reasons You May Struggle To Get A Diagnosis And The Right Treatment At Physical Therapy

Craig Smith November 16, 2023

Upon your arrival at Smith Performance Center, our primary goal is to comprehensively understand the source of your pain or symptoms. Our physical therapists initiate this by gathering crucial information through a medical history form, conducting detailed interviews about your experiences, performing thorough examinations, creating an initial list of potential diagnoses, validating our hypotheses through treatment, and finally, devising an initial home plan. This phase in our rehabilitation process is aptly termed ‘Diagnosis and Home Plan Development’. While not creatively titled, it accurately encapsulates the process our team undertakes. A concrete diagnosis is pivotal for us to confidently provide effective assistance. However, arriving at a diagnosis can be challenging due to various reasons. These complexities range from the diverse causes of pain (such as injury, inflammation, nerve-related issues, sensitization, psychogenic factors, and dysfunctional conditions) to individual-specific challenges. Some individuals struggle to articulate their experiences effectively, while others may not exhibit

What are the phases at Smith Performance Center?

Craig Smith November 6, 2023

At Smith Performance Center, we focus on the main problem of the client. This focused process revealed a recurring set of problems that many of our clients experienced. This led to an overall process we call SPC Phases. There are 5 phases for our clients at Smith Performance Center: Diagnostics and Home Plan Development, Symptom Stabilization, Activity Progression, Exercise, Maintenance, and Monitoring, and Maximize Performance. Each phase consists of a main problem, the common challenges experienced by the clinician, coach, and client when managing your problem, steps to achieve along the way, and a promise for what you get when you complete the phase. We believe a clear process matters to your overall success. We want to explain the problem, common challenges, steps to achieve, and the promise. The Focus On A Problem The focus of a phase is the problem being solved. In Diagnosis and Home Plan Development, we

When and where you feel foot pain during walking is key for diagnosis

Craig Smith September 27, 2023

When and where you experience foot pain during walking is diagnostic. This means we can figure out the pain generator. That is a large list. It can be the fat pad, your fascia (the most common, incorrect diagnosis), plantar intrinsics (muscles on the bottom of the foot which is primarily the flexor digitorum brevis, abductor hallucis, and abductor digiti minimi), the flexor hallucis longus, the tibial nerve, the medial or lateral plantar nerve, the calcaneus, the talus, the bones of the midfoot and forefoot, the foot and ankle joints, ligaments, the hallux (big toe), or the little toes. It does not include referral into the foot from your low back or hip. With the foot, we know when the different structures that can cause pain are loaded during walking and we know that the location of pain is likely where the pain generator resides because of the higher receptor field

7 Tools to overcome invisible triggers stalling your rehab progress

Craig Smith June 22, 2023

An invisible trigger is a problem that can stop you from fully healing. 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 properly. During the course of treatment, our team comes across this problem frequently when a patient will seem to stop progressing in their rehab plan. This problem presents most often during the symptom stabilization and the activity progression phases. The physical therapist will see an improvement in symptoms during a session, but then progress is lost when the patient tries to manage the symptoms on their own. During activity progression, there is often an interaction between the activity being progressed and normal daily activities. Do you have this problem? If you say yes to the following, an invisible trigger is not being addressed. Pain keeps returning when

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

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

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

5 Steps To Develop A Diagnosis In Physical Therapy

Craig Smith September 2, 2020

“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

Knee Pain and Physical Therapy

Craig Smith August 31, 2020

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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SPC Archives

Tag: diagnosis

The 7 Home Plan Mistakes Ruining Your Progress in Physical Therapy

5 Reasons You May Struggle To Get A Diagnosis And The Right Treatment At Physical Therapy

What are the phases at Smith Performance Center?

When and where you feel foot pain during walking is key for diagnosis

7 Tools to overcome invisible triggers stalling your rehab progress

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

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

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

5 Steps To Develop A Diagnosis In Physical Therapy

Knee Pain and Physical Therapy

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