Smith Performance Center - Physical Therapy & Strength Training

While I am biased towards taping for foot control, another effective option is bracing. Braces can confirm diagnoses, supplement poor movements, improve the ability to self-manage, and aid in activity progression. In this video, I discuss when to use a brace as a diagnostic tool, a crutch for healing tissue, or a training aid to avoid overloading tissue capacity.

Strap-type braces can be effective, but their placement can be tricky. My favorite technique involves creating Foundation 1, setting the right pull, and completing Foundation 2. This simple setup works for any strap-style brace meant to provide supportive force.

Watch the video to see an example of this technique in action!

The 3 keys to putting on an adjustable ankle strap for posterior tibialis and plantar heel pain Discover the best tools to help unload the posterior tibialis, plantar fascia, and plantar intrinsic muscles. One of my favorites is the post tib brace. Whil...

For experienced exercisers returning from injury, you can get stuck in a loop of feeling better followed by a flare-up, over and over again. One significant reason for this is the intensity at which you resume training.
Why does this happen?
Over time, your brain gets accustomed to a certain intensity level, viewing it as necessary for a productive workout. However, post-injury, this intensity is often too high for your compromised tissues.
This overreach can be hidden.
While you might get away with it for a couple of sessions, you’re likely pushing the healing tissues back into an injured state, forcing you to back off again.
At Smith Performance Center, we call this “violating the rehab standard,’ which simply means you are trying to push your exercise capacity when your tissue capacity is lower.
If you continually cycle between being injured and training without seeing significant progress, it’s a sign that your training intensity is set too high too soon and not at the appropriate problem.
Here are a couple of tools that will help you:
Use braces when building volume. The brace can be on for portions of increased volume or cycled on and off during the workout.
Monitor key signs specific to your injury that are more sensitive to a flare-up. For example, a simple low back screen consisting of a forward fold, extension, and side-to-side movement can catch an irritated spine early instead of waiting to see pain the next morning.
Monitor for interactions between your exercise and other daily activities. Common ones are sitting after your workout or the time of day you exercise.
Change the goal of the workout to feeling good instead of feeling exhausted.
Pick one variable to progress at a time. I like building up volume first prior to increasing intensity.

Read more about this problem https://bit.ly/3y95TVT.

The 5 Most Useful Tools for Progressing Your Workouts After an Injury - Smith Performance Center Too many fail in their effort to progress activity after an injury. You arrive at the gym feeling good but later in the day the low back soreness that has been feeling better comes back or the knee pain that seemed to be going away comes back with a vengeance after your second run. The […]

Our first SPC Seminar in the new building was a success! This is a new service that we will be offering our members and hope to open up to the community in the future. Craig hosted a wonderful and thought-provoking workshop on the challenges of maintaining an exercise routine.

Despite the widespread belief in the health benefits of exercise, less than 25% of Americans meet the minimum guidelines for physical activity. We know the number one reason people stop exercising is injury and pain.

Many of our members started at SPC because of this problem. However, it’s not the only reason, and it's crucial to explore what factors could lead to a life of inactivity. During this interactive workshop, we discussed why exercise is hard, how to create a lifelong commitment to an active lifestyle, key motivators and demotivators, and essential skills and tools for staying active.

Stay tuned for future workshops! We have a lineup of various topics that we are excited to share with you all.

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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 rapid responses to treatment due to the absence of a clear injury. Additionally, some cases involve multiple factors contributing to the pain, where treating one might exacerbate another.

We term these challenges and they are prevalent in the diagnostic process.

Here are the primary reasons you might encounter difficulties in obtaining a diagnosis and the appropriate treatment:

1) Compromised Feedback Loop
2) Treatment Issues
3) Injury Presentation
4) Issues with Diagnostic Information
5) Patient Reporting

Understanding and addressing these challenges is crucial in ensuring an accurate diagnosis and devising effective treatment plans for our patients.

https://smithperformancecenter.com/5-reasons-you-may-struggle-to-get-a-diagnosis-and-the-right-treatment-at-physical-therapy/
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It's been a great first 2 weeks in our new facility.

Thank you to all of our members and staff who have helped this transition go so smoothly. And a huge congratulations to Craig & Sarah Smith!

If you haven't had a chance, stop by and check it out!

5602 East 5th Street, Tucson AZ 85711

After helping over 4,000 people at our location off of Pantano and 22nd, our business is moving to a completely renovated location off of 5th and Craycroft.

We are excited for the change and look forward to helping more individuals in our community over the next few years.

If you have any questions or need help with pain, an injury, getting back to activity, or developing an exercise routine schedule online at www.smithperformancecenter.com or give us a call at (520)398-4886 and we'd be happy to help!

We hope to see you there!

Creating a single, hard workout is easy.

Creating a series of workouts that improve your overall fitness is not.

Creating a true program that builds your skill set, builds your confidence, and adjusts for soreness or an emerging injury is extremely difficult. In the same vein, it is not hard to develop a physical therapy exercise list that targets a single problem, like glute inhibition. It is much harder to progress post-injury using strength training when we need to push the edge of the tissue capacity. Programming a workout needs to consider numerous, modifiable variables. Remember a modifiable variable is anything you can change in the workout to optimize the training session and the overall programming scheme.

At a minimum, you need to consider intensity, sets and reps, rest intervals, frequency of workouts, and supersets. The minimum however does not optimize your workout and sometimes these are not the most critical or important variables.

We are going to go deeper into a few modifiable variables that are often not considered that can make or break your success:

Prep Exercises and PT Additions

Exercise Choice

Artificial Stabilization

Recovery Activity

Continue reading our blog post: "The 4 Unique Training Variables Used By Our Team To Improve Workout Success" https://smithperformancecenter.com/the-4-unique-training-variables-used-by-our-team-to-improve-workout-success/
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Too many fail in their effort to progress activity after an injury.

You arrive at the gym feeling good but later in the day the low back soreness that has been feeling better comes back or the knee pain that seemed to be going away comes back with a vengeance after your second run. The regression happened even when the workout felt easy and pain-free at the time. Why is this happening? Why is this phase of rehab frustrating?
It’s due to a fundamental mistake or what we call a violation of the rehab standard, which is training at exercise capacity, not tissue capacity.

We want to help you understand the principle of tissue capacity and exercise capacity and why it may be the reason you keep having the same setbacks.

Continue reading our blog post: "The 5 Most Useful Tools for Progressing Your Workouts After an Injury" https://smithperformancecenter.com/the-5-most-useful-tools-for-progressing-your-workouts-after-an-injury/
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Warm welcome to our newest coach, Spencer Roberts! He has been a member of SPC for over 4 years and has been in the health and fitness industry for over 40 years. Spencer was one of the first trainers Craig met in Tucson back in 2008. We are so excited to have him as a part of our team! 
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During the course of treatment, our team comes across these problems frequently when a patient will seem to stop progressing in their rehab plan. These problems present most often during the symptom stabilization and the activity progression phases. Our physical therapists 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.

 With these tools, we can help you overcome your invisible triggers. 

Learn more about each of these tools in our latest blog post linked below.

https://smithperformancecenter.com/7-tools-to-overcome-invisible-triggers-stalling-your-rehab-progress/
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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 properly. 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 will stop doing obvious triggers, but this does not always happen with invisible triggers as these can be a little more tricky to identify.

Learn more about the components of invisible triggers in our latest blog post linked below.

https://smithperformancecenter.com/the-5-components-of-invisible-triggers-that-cause-your-rehab-progress-to-stall/
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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.

Click the link below to read more in our most recent blog post:

https://smithperformancecenter.com/four-reasons-why-patient-forms-help-improve-your-care-during-your-rehab-process/
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During the movement assessment, the 6 foundational movement patterns are assessed with 6 functional exercises from each movement pattern category.

The movement assessment is where our strength coaches determine what may cause issues in your program: accountability, rehab standard, location/time, coaching need, and comfort level.

These 6 functional exercises help our coaches determine your coaching need, if you have a tissue capacity issue, your comfort level with free weights, and what is the right level of programming for you.
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The 6 Functional Exercises Tested During a Movement Assessment - Smith Performance Center A mistake in exercise programming that our team encounters is a heavy emphasis on variety in exercise, instead of movement pattern mastery. Our team does not focus on an endless array of exercises. The focus is on building depth in...

The Smith Performance Center team strives to be the best in the world at helping clients who want to maintain an active lifestyle.

If you search the internet, this seems like a simple problem to solve. Just do this exercise or make sure you have protein after a workout. Problem solved. This has not been our experience. There is an entire area of research devoted to what behaviors keep people moving and what makes them stop. Keeping people active is not simple and there are numerous reasons why a person will stop.

The purpose of the movement assessment is to figure out issues that will stop you from moving. There are clues in your history, how you move, how you hurt, and how you think that will help guide us.

Here are the 8 reasons we do the movement assessment:

1) Figure out what may lead to failure

2) Determine the right exercise pool and starting point

3) Schedule an open clinic with a physical therapist if there is pain or an injury

4) Understand coaching need

5) Explore your comfort level in a gym (group or individual training setting)

6) Monitor your response to functional movements and first exercise experience

7) Increase familiarity with the HHP Program

8) Provide recommendations that will help you lead an active lifestyle

In this article, we dive into each one of these reasons with a more in-depth explanation of our process. Click the link below to continue reading.

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The 8 Reasons All HHP Clients Go Through a Movement Assessment - Smith Performance Center The Smith Performance Center team wants to be the best in the world at helping clients who want to maintain an active lifestyle. If you search the internet, this seems like a simple problem to solve. Just do this exercise...

During your physical therapy session, it is important to get very clear on what the patient is reporting. There are 5 patient responses that we care about in the session: great, good, bad, terrible, and no response.

In an effort to get clear thinking, we only categorize a great response as greater than 80%. This reduces the likelihood that the patient’s response is purely placebo while increasing our confidence in our current hypothesis.

If it is positive but not 80%, then it’s a good response.

If there is no change no matter what we do, then we categorize it as no response.

If they feel a worsening of symptoms, that is considered a bad response.

A terrible response is when the patient gets dramatically worse, nothing helps, and we can no longer apply the treatment.

Read more in our blog post below.
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The 5 Patient Responses That Should Impact Your Physical Therapist's Strategy - Smith Performance Center 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...

SVP's 8th Annual Fast Pitch Event is Tomorrow!

Thank you to our judges who will be there to select the winner of The David and Lura Lovell Foundation Judges' Award for $10,000!

We are honored to have you join us from The David & Lura Lovell Foundation, TMCOne, Community Foundation for Southern Arizona, Tucson Electric Power, Banner - University Health Plans, Smith Performance Center - Physical Therapy & Strength Training, Meridian Wealth Management, LLC, and World View!

Our coaches work together to continuously test new exercises, program for clients, and create effective workouts for both personal training and group sessions. They collaborate as a team to use SPC methodology with a creative touch, all while motivating and guiding our members to achieve their goals.
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Uncertainty is a common problem in physical therapy.

The greatest uncertainty is how long it will take for you to get better. This is impacted by every aspect of care.

There is not a testable and measurable timeline. Patients are not told clearly when they should expect to be better and how they can help. They are not invited in as collaborators and team members in trying to reach a proposed ‘deadline’. Basically, you go to physical therapy 3 times per week for 8 weeks even if it is not needed. This creates frustration due to the lack of a clear plan and limits ex*****on.

Our team developed a tool to get at the heart of the problem: the 3-level prognosis.

It is a simple, flexible tool to outline the uncertainty as clearly as possible. The tool forces the first session conversation to include the unknowns. The 3-level prognosis makes everyone involved clear on their roles, what to expect, and when to expect it, which gets at the root of one of the biggest problems facing healthcare and physical therapy: unavoidable uncertainty.
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How long till I get better? 3 Level Prognosis - Smith Performance Center Will you get better? How long will it take? There is uncertainty in outcomes and prognosis. Learn how we use uncertainty to improve outcomes.

Our physical therapists are limited to 28 sessions per week.
They do not have more than 6 full sessions per day.
They are paid and given time to document.
Each therapist has their own office, not a shared space with other patients and clinicians.
We spend 2 hours each week reviewing patient cases to test our assumptions and strategies.
We update our operating system regularly to fix issues and promote best practices.
We use structured tools to improve thinking while reducing decision fatigue.
Our quarterly update reviews all of the data produced by our actions for opportunities to improve.
We even publish our data through program evaluations.

This is different from other physical therapy businesses.

Why?

Our business model is driven by patient outcomes. This structure makes outcomes matter. The better the outcomes, the more people who come to see us.

Its starts with creating the best environment possible for our physical therapists to think.

It is impossible to focus if you are completely drained from seeing multiple patients per hour for the entire day.

It is impossible to think effectively if you are constantly switching from one patient to another.

It is impossible to think deeply about a patient experience if you only get 15 minutes (and this is being generous) prior to moving on to another patient.

It is impossible to expose cognitive errors if you do not regularly review your process and look for ways to make it better.

If documentation is a burden that does not help beyond getting reimbursed, you cannot use it as a tool to help your patients.

When we started, we were told that a patient would not come to our clinic because there was no difference between our service and other physical therapy providers. With the large influx of national physical therapy companies, it seems like physical therapists are expected to operate in an environment that ruins the effectiveness of our profession. If you wanted to create an environment that limits your ability to think, it would be hard to find a better setup.

We value the energy and time it takes to think through a patient's problem.

We enjoy taking on complex problems.

If the clinic you go to makes it look like your problem is obvious and only takes a few seconds of thought to get to the right answer, then you might benefit from a different model of physical therapy.

Send a message to learn more

Diagnosing the structure causing your pain is critical for physical therapy. Oftentimes, you may think a diagnosis is obvious, but this is rarely the case. There needs to be a process to make certain the diagnosis is correct in order to allow for the treatment and plan of care to be decided.
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Diagnosis in Physical Therapy - Smith Performance Center Your physical therapy diagnosis should be updated, questioned, and refined until you feel better. Learn more about this dynamic process.

At SPC, we continuously strive to improve patient outcomes. One example of how we do this is by holding weekly "Learning Meetings" to collaborate and problem-solve around diagnoses and treatments. We work as a team to review case studies and clinical thought processes, to continue to grow and push the boundaries of how we practice.
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We consistently see the same mistakes when patients show up at our clinic with longstanding pain and injury. Often, their previous providers have made a mistake in their process that leads to bad outcomes. As a patient, you can learn from these mistakes to get better faster and we are here to help.

https://smithperformancecenter.com/5-rehab-mistakes-and-how-to-solve-them/
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5 Treatment Options to Reduce Knee Pain without Surgery, Injections, or Drugs

There is not a single treatment answer for every type of knee injury. Part of our PT Solutions Methodology here at SPC uses the treatment hierarchy and a retestable key sign to determine what treatment works best for you. If a clinician defines themselves by a single treatment, they are missing out on numerous tools that can help their patient.

Read More Here: https://smithperformancecenter.com/5-treatment-options-to-reduce-knee-pain-without-surgery-injections-or-drugs/

Visit our website and check out more helpful articles on our blog page!
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Address your injury with Smith Performance Center. Our Physical Therapy Solutions (PTS) process will help you return to activity with a clear diagnosis, effective treatment, and a focused plan to get you back to the activities you love.
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Reach your potential this year with Smith Performance Center. Let us help you start the year off right!
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Here at SPC, we believe your lifestyle shouldn't be limited because you are in pain. This is why we provide focused physical therapy, long-term management of chronic, recurring injuries, and a healthy living program.

We appreciate our amazing team of physical therapists and are so grateful for their knowledge, collaboration, and service to our community.
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SPC continues to support the community by guiding people to lead an active lifestyle through physical therapy and strength training. Our admin team works together to make sure our business is running smoothly and provides high value service to our members.
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Our Health and Human Performance program is designed to help you take control of your exercise journey, get stronger, and move better with expert strength training and conditioning. We currently have three awesome coaches on our team to guide you and help you reach your fitness goals.
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