PErformance Based Physical Therapy

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​   Welcome to my first official blog post. This is an exciting day for me as I am two months in to the start of my own performance based, out of network, physical therapy practice (RecoverRx Physical Therapy). Many people often ask me what is performance based physical therapy? Is this specific to athletes or open to everyone? Also, another popular question but more appropriate for a whole additional blog, “Do you take my Insurance?”

   These are indeed great questions, and there are many more where they came from. If I were to define performance based physical therapy, I would combine a couple different definitions from some of my colleagues and mentors in the field,  Danny Matta and Mike Reinhold, among others. Performance based physical therapy is physical therapy provided to athletes of all age ranges and high performance individuals alike in a performance based gym or clinic setting, mixing traditional physical therapy assessment and intervention with progressive strengthening and mobility protocols to reduce pain and optimize performance.  Therefore, we must talk about “performance.”

    Performance is a term that seems to have a connotation with athletes only, but can and should be associated with performance in any aspect of our lives. Whether that be with your 1 rep max back squat, ability to hike 10 miles, play soccer on the weekends, or simply be able to throw a baseball with your son. All these different activities have a different meaning for every individual, but I think we can all agree that we should all be able to perform at an optimal level in any passion of ours. I believe most people have that vision of what their optimal performance looks like even if it is a mirror image of themselves in their 20s or of them modeling their fitness idols now. We should never dismiss this or any vision as unattainable.

    Throughout my years as a performance based physical therapist, I have realized that if this vision turns in to a mindset shift, then pain or physical limitations cannot stop you from achieving your vision of optimal performance. I have seen patients climb Mt. Kilimanjaro 6 months after ACL reconstruction, Clean and Jerk 185 lbs. following rotator cuff surgery, and run a marathon following 2 years of pain and not running. The key to their success was a mindset shift away from what their limitations are to what they could achieve.

 “Nothing can stop the man with the right mental attitude from achieving his goal; nothing on earth can help                                        the man with the wrong mental attitude.” – Thomas Jefferson

   This is where Performance Based Physical Therapy helps people along their path to high performance. Being able to rehab in an environment focused on their performance goals allows people to keep their vision alive. Assessing peoples’ functional movement patterns i.e. hip hinge, squat, lunge, overhead shoulder position etc.. as well as assessing for mobility, flexibility, and strength impairments lays the ground work for developing a performance based approach to rehab. Also, allowing people to have input in to their recovery and presenting a progressive program gives people the accountability they need to stay in it for the long run.
   
​   I think a main frustration among many traditional physical therapists is the lack of compliance by patients as well as lack of grit needed to achieve the long term goals of self-sustained pain management and self-optimization. With Performance Based Physical Therapy, there is constant communication with the patient to give them the small changes in their programming over the long haul to achieve their goals. They develop the grit they need to see it out to the end. And that’s what it takes, a little “Vision, Mindset, and Grit” (Shout out to Scott Burrows book) to “Recover, Rebuild, and Redefine” yourself. 
Thanks for Reading!
​Luke Greenwell, PT, DPT, CSMT, CSCS