knee pain - Smith Performance Center

A clinician at Smith Performance Center performing manual therapy, assessing elbow range of motion. Hands-on assessment techniques help diagnose movement limitations and guide treatment

Meniscus Tears & Knee Pain: Why Rehab Needs More Than Just Cutting Out the Problem

Craig Smith February 15, 2025

The Evolution of Thought Around Meniscus Injuries Clinical practice is filled with successes and failures. For some reason, failures tend to linger in memory the longest and often drive the biggest changes in how we approach patient care. A significant moment in my clinical career involved a meniscus tear, knee pain, and the need for surgery. One of the most impactful shifts in my approach to knee pain, particularly in cases involving meniscus tears, came from a repeated clinical pattern: patients improving, then regressing, over and over. This frustrating cycle forced me to rethink my process and align it with a more structured framework—one that incorporates the Smith Performance Center Phases. This helped me answer the question, “Does a meniscus tear require surgery, or can it be successfully rehabbed without going under the knife?” The Traditional View: Meniscus Surgery vs. Rehab For years, meniscus tears were considered a primary cause

Craig Smith, PT, DPT, conducts a knee exam at Smith Performance Center, demonstrating expert physical therapy techniques in knee pain assessment, rehabilitation, and injury recovery while flexing his arm in a lighthearted moment.

Total Knee Case Study: Why You Need A Structured Rehab Process

Craig Smith September 29, 2023

A structured rehab process that ultimately targets a full return to activity is missing in healthcare. Patients struggling with pain are treated as if they are all the same. We believe there are common, big problems to address, but there is a high degree of uncertainty with every patient presentation. Even when a patient has the same diagnosis they can have different triggers, different contributing factors, different behaviors, and drastically different needs in the rehab process. This is true when patients have the same surgery by the same surgeon. Let me use an example with a straightforward rehab plan; post-total knee replacement. The Painful Total Knee Replacement Peter Pain had a total knee replacement. He has always been active and handles pain well but this replacement has been horrible. First, he fell behind on medication post-surgery because he hated the way the drugs made his stomach feel. The second day

Self Knee Traction

Sarah Smith September 7, 2020

Partner Knee Traction

Craig Smith September 3, 2020

Knee Pain Meniscus Degeneration and Clinical Experience

Craig Smith September 1, 2020

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

Knee Pain and Physical Therapy: A Structured Approach to Recovery

Craig Smith August 31, 2020

Updated by Craig Smith February 22, 2025 Understanding Knee Pain: Why Won’t It Go Away? Knee pain is a common and persistent problem that affects daily life. Whether you’re avoiding stairs, switching from running to biking, or waiting for a knee replacement, chronic knee pain can disrupt your routine. And it is more complicated than we often admit or see online. At Smith Performance Center, we believe that effective knee pain treatment requires more than just exercises or quick fixes—it needs a structured plan. This is where our SPC Phases come into play. Our phase-based system ensures that each step of rehab is intentional, guiding patients from pain relief to long-term performance. This article explores why knee pain occurs, how physical therapy should address it, and what steps you can take to regain control over your movement. Why Is Knee Pain So Common? The knee may seem like a

How & When to Use a SERF Strap

Craig Smith April 4, 2018

What is the SERF Strap? The SERF Strap is the first patellofemoral brace designed to treat PFP due to poor hip control. Basically, the strap is a really long elastic band that you anchor at the knee (my term is foundation 1), tension over the outside of the thigh, and anchor around the pelvis (foundation 2). When you create these anchor points, the strapped leg will now have support for external rotation at the hip joint. This reduces pelvic drop and knee valgus. You can take someone whose knees hit together and immediately correct this dysfunction. While the marketing material and websites talk just about patellofemoral pain, I use this tool for symptoms in the leg (sometimes the back) during the stance phase of running or walking. This includes injuries like posterior tibialis tendinopathy, adductor longus and gluteus medius injury, and trochanteric bursitis. For athletes, I prescribe it as an

Factors to Consider After Knee Injury

Craig Smith April 26, 2017

Returning to Activity, Physical Therapy, and Neuromuscular Fatigue Neuromuscular fatigue has been implicated as a significant problem for individuals returning to sport following an anterior cruciate ligament (ACL) injury and reconstruction. Due to the high rate of re-injury in those that have had an ACL reconstruction, one hypothesis is that neuromuscular fatigue will negatively impact strength performance, postural stability (single leg balance), and biomechanics during jumping and landing. It blows my mind that a female athlete with an ACL tear is 16 times more likely than a healthy female athlete to tear an ACL again. The interplay between a previous injury, the resulting changes to the input to the brain, modified motor planning, and re-injury is an interesting development in research. Today I wanted to dive a little more into fatigue, its impact on biomechanics, and how physical therapy and strength training can start to augment the problem. There

visual dominance process after a knee injury

The Effect of Knee Injury on the Brain

Craig Smith April 18, 2017

Physical Therapy Research The connection between your knee, an injury, and the brain is not straightforward. However, when you hurt your knee or any other joint there can be issues that lead to future problems. A recent article dove into this topic: Grooms D, Appelbaum G, Onate J. Neuroplasticity following anterior cruciate ligament injury: a framework for visual-motor training approaches in rehabilitation. J Orthop Sports Phys Ther. 2015;45(5):381-393. Why is this important for physical therapy? The control of our body is dependent on three systems: visual, vestibular, and somatosensory. The visual system contribution is obvious – the eyes. Due to changes in information coming from the body (somatosensory) due to the ACL tear, the motor control system becomes more reliant on the eyes. If we focus on retraining the body without disrupting this natural progression to visual dominance, the athlete will be at risk for injury as they progress to

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SPC Archives

Tag: knee pain

Meniscus Tears & Knee Pain: Why Rehab Needs More Than Just Cutting Out the Problem

Total Knee Case Study: Why You Need A Structured Rehab Process

Self Knee Traction

Partner Knee Traction

Knee Pain Meniscus Degeneration and Clinical Experience

Knee Pain and Physical Therapy: A Structured Approach to Recovery

How & When to Use a SERF Strap

Factors to Consider After Knee Injury

The Effect of Knee Injury on the Brain

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Updates from Smith Performance Center

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From Pain to Progress: Building an Exercise Habit After Injury