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Tag: Rehab Process

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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Smith Performance Center Tucson

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

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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

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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

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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

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What are the 3 major issues in physical therapy and exercise?

Craig Smith September 25, 2023

The quality of physical therapy is not consistent between clinicians or clinics.  There are numerous reasons causing the differences: the overall rehab process, the management, how the client pays for the service (insurance, Medicare, cash, etc.), the time available between the clinician and patient, the use of assistants, the number of patients per provider during an hour, the clinical skill set, and training of a specific physical therapist. This is far from an exhaustive list.  These issues result in a pervasive underperformance in rehab outcomes for clients. The 3 major issues in physical therapy and rehab When starting out on a rehab journey, you will not think about these problems – you just want to feel better. But these issues matter and directly impact your outcome.  The major issues in physical therapy fall into 3 critical areas: Process, Patient-Provider Relationship, and Clinical Skill. Together, these drive the difference in experience

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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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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

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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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