When I founded KPR in 2021, we were the only Performance PT clinic in the triad. It was a really scary and surreal experience being the first to explore a different realm of PT.
Since that time, several other business have opened who have followed our footsteps. Even though this means more competition, this is overwhelming good because more people will have access to high quality PT.
The way I see it, our only true competition is the inaccurate idea of what people think "physical therapy" is and what it should be.
So, let's dive into our rehab model and I'll show you why it makes practical sense and is superior to the PT of old.
Our model:
At KPR we use the 13 model of rehab. We didn't invent this, it was created by people much smarter than us. We simply adopted and adapted it to fit our business and put our own spin on it.
This model was created to encompass the injury cycle and the ENTIRETY of recovering from injury and not solely getting people out of pain. So lets break it down stage by stage.
Injury:
This is the traditional pain/injury phase of rehab. This encompasses tissue irritability, injury, or post surgical recovery.
Unfortunately, the entire traditional PT model lives within the first "I." People are referred to PT with pain. Once they have less pain, and/or are deemed "functional" (can get dressed, walk, do basic life things) by their insurance company they are discharged.
This is where traditional PT lives and dies. This is pretty straightforward so I won't spend a lot of time here.
Incomplete mechanics: This refers to specific deficits that a patient may have when performing their fitness activities.
These things could include:
-range of motion limitations
-strength deficits
-motor control deficits
-lack of skill or coordination
-altered movement mechanics when performing a skill
-fear avoidance of movement
These are often ROOT causes or compounding factors that onset the original injury.
Unfortunately due to the constraints and limitations of traditional rehab, few, if any of these issues are often corrected in regard to specific activities (barbell movements, running, etc).
Example: A squatting athlete goes to a rehab clinic. Rehab includes table exercises and telling patient not to squat. The clinic doesn't even have a squat rack or barbell. Pain decreases, the patient is discharged without ever looking at assessing or addressing the most important factors that led them to be there.
This phase is one of the reasons, why so many people complete rehab end up re-injured or in pain when they return to their specific training.
We've highlighted these sections green in our diagram to show that our expertise starts where traditional rehab ends.
If squatting with heavy weight is a fitness goal of yours. Don't you think your PT should help you navigate and optimize your squat mechanics and make sure you can tolerate load before booting you out the door?
We certainly do.
Incidents: This refers to tissue capacity, repetitive stimuli, and/or repeated "micro" injuries.
The way that I think about this stage of rehab is simply: "capacity to tolerate load".
This is generally the most "fun" stage of rehab, when you are prepping for full return to whatever your fitness goals of choice may be.
Let's take a CrossFit athlete with shoulder pain for example:
CrossFit has a very high shoulder demand. You MUST be able to:
-press overhead
-turn over a barbell and master the 90/90 transition
-develop open (non fixed) and closed chain (fixed) shoulder stability
-tolerate hollow and head through positions for gymnastics
This is just to name a few.
The purpose and beauty of this stage of rehab is systematically prepping tissues to tolerate those SPECIFIC challenges.
At KPR, we have the flexibility to connect the demands of training with your injury history. Successful rehab is only successful when you've fully reintegrated into training and are ready for the demands of your modality.
For a patient with a knee injury wanting to compete in a competition with 150+ pistol squats... we built up to high volume pistols.
For a patient with hip pain wanting to trek across Spain.... we hammered box step ups, lunges, heavy squatting, and took her walking volume from 1/4 mile (injured) to 6-7 miles per day.
If you skip this stage and never let your tissue prepare for your task at hand, your likelihood of ending up back in the "INJURY" stage is high.
The likelihood that you did all your rehab for nothing is high.
The likelihood that you wasted a bunch of money and time is high (cough *we're looking at you traditional rehab).
Performance: This is our personal spin on the 13 model. This signifies completing ALL of the phases of rehab and finally getting to the OFF ramp from INJURY to PERFORMANCE.
Performance gains are theoretically infinite.
We see this more as a starting point.
Where the focus shifts from rehab to performing. Where you're fully reintegrated back into your sport (CrossFit, running, golf, HIIT, spin, hiking, etc) of choice.
If you don't ultimately end up at this point, was your rehab truly successful?
We don't think so.
If you're a retiree and your life activities include doing house chores, getting to/from the bathroom, getting dressed, etc..... then traditional rehab is more than enough to get you where you want to go.
If you're a fitness athlete trying to lift heavy, run far, or push your physical/mental limits then WHERE and HOW you rehab matters.
About half of our patient load comes from individuals who have "failed" rehab at a traditional clinic.
This failure was do to the neglect of the later 2 stages and reintegration back into their sport.
Don't let this be you. If you're a fitness athlete, do it right the first time. Rehab in a way that helps you perform and keeps you injury free in the future.
Complete the cycle.
Get off the hamster wheel of injury, rest, rehab, repeat.
If you need help, you know where to find us.
As always, stay kinetic friends.
Dr. Levi Kerby is a physical therapist, orthopedic certified specialist, and owner of Kinetic Performance and Rehab in Winston-Salem, NC. He enjoys fly fishing, guitar, various forms of fitness, and treating active and motivated individuals.
If you're dealing with an injury or pain, you can contact Kinetic Performance and Rehab directly below.
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