Perry Smith, Nashville fitness expert is the founder of Perry Smith Fitness Concepts. He practiced physical therapy for over 20 years and is an expert in the biomechanics of movement. Over the past 15 years, Perry Smith has channeled his passion for health and wellness into initiating and expanding two successful physical therapy businesses in and around the Nashville metro area.
Perry Smith holds a BS in biological science from the University of Alabama at Birmingham, and earned an MS from Emory University, whose program ranked in the top five nationwide. He has done extensive continuing education and is certified in IDN and SFMA.
Perry Smith helped lead both physical therapy businesses to profitability in under 6 months, yielding an average yearly net profit growth of 23% over a 16-year period.
Describe a couple of challenging cases you’ve had and some of the methods you used to treat them.
I have spoken often on the benefit that motion capture technology has in physical therapy. It opens a different window of becoming aware of and examining abnormal movement patterns. Once I had a high school basketball player referred to me for lower back pain that had completely sidelined his playing. He had been evaluated and treated by several other clinicians and still was unable to play. This was a huge devastation because he was in his junior year of high school and being recruited by universities.
When I have clients that have been treated by other clinicians without success one of the first things I tell them is we do not want to “recreate the wheel”. Obviously, your prior treatment plans have not worked, and do not want to simply hope more of the same will work. We need to find what others are missing. This is where motion capture is invaluable. Within 30 minutes of his being in my office, we had completed his motion capture assessment and found a glaring problem. When he was doing vertical jumps his left ankle was not flexing adequately to participate in the absorption of force when he was landing.
As we watched the video you could literally see the ankle not move the way it needed to and the knee, hip, and eventually back have to compensate to attenuate the force of landing. He revealed that his medical history included a significant left ankle injury and although he thought his ankle had recovered adequately to return to play he had nowhere near the needed ankle mobility required for the ballistic movements involved in basketball. The body always has to attenuate force applied to at through various tissues of the body and if it isn’t attenuated where it is supposed to be it will wreak havoc somewhere else. For this player, his lower back was simply the victim and the true culprit that had to be addressed was his ankle. After 6 sessions to restore ankle mobility and retrain movement patterns he returned to playing without pain and was able to earn a Division 1 basketball scholarship.
How do you develop client treatment plans?
One of the biggest pitfalls new physical therapists can fall into is “chasing the pain” and developing treatment plans based on that. There are normative data of how the human body moves ideally and though none of us have 100% ideal movement patterns the closer we come to that mark the more pain-free our bodies function. Therefore, my list of objectives comes from deviations from the ideal norm of movement. As far as how I achieve those objectives it goes back to a statement one of my educators used to say…” first you make it possible, then you make it happen”. This means that first, you have to remove any impediments to ideal motion happening. This could be reducing swelling, restoring joint mobility, removing muscular adhesions. Secondly you “make it happen” which means once the capacity for correct movement is available then you retrain the body in the desired movement pattern. The end result is a more symmetrically functioning pain-free body.
How do you keep clients informed of progress/status?
A picture is worth a thousand words. When you show them a video of the asymmetries of their posture and movement patterns before and after treatment it shows them proof of changes happening in their bodies. Typically this will correspond with them recognizing and reporting a steady decrease in their pain level without previous compromised activities.
How do you encourage clients to adhere to their treatment plans?
Most clients are very motivated to get better and will follow their plans. If they are not I simply point out to them that their best plans have got them where they currently are which is injured and in pain and they are spending their money for my help so it simply does not make sense to let me guide them to a better level of health.
What are some of the challenges of working with geriatric patients?
A good physical therapist can always improve a person’s level of health and well-being and typically recover from many injuries. But as one of my professors at Emory University stated it “you have to work with the body that walks in the door”. We all accumulate wear and tear on our bodies as we age and there are times that the tissue or joint has been degraded to the point that treatment options I could provide may not be beneficial and they may be at the point of needing other intervention such as a joint replacement.
How do you define and measure client success?
A person who is functioning at a higher level of health and whose attainable goals have been met. Additionally, a person who understands and appreciates their health and feels more educated and empowered to care for it.
What’s your top health and wellness recommendation?
As with all things caring for your health is about moderation. It is a marathon, not a sprint. It is not about yo-yo-ing back and forth between sprinting and walking. Caring for your health is about consistency and pacing so you finish as strong as you start.
We want to thank Perry Smith for sharing his insights and experience with our readers.