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Dr. Ashley Smith, PT, DPT

@dpt_ashley

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Join us for a virtual guest speaker event! Sports SIG is excited to welcome Ashley Smith, PT, DPT, a Sports Performance Physical Therapist at Healthy Baller! Ashley will be sharing her experience and knowledge in injury rehab, return to sport, and sports performance, followed by a Q&A session. This is a great opportunity to learn more about the field of sports PT and ask questions! 📅 Thursday, October 15th ⏰ 7:30 PM 💻 Google Meet We hope to see you there! Sign up below to receive the Google Meets link! https://docs.google.com/forms/d/e/1FAIpQLSf5TjygNO_xSoqcDSwkWDci245TUo5bTjeL68XTxFbtJYJaeQ/viewform
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Introducing Between Sets, a glimpse at the random conversations I have with patients while they rest between sets 🗣️ In Episode 1, Cole gives his NFL Week 3 hot takes and picks, game by game. Drop your thoughts on his takes below 👇🏼 #sportsPT #NFL #sportsrehab #hottakes
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🔸 ACL or PCL tear? 🔸 This soccer athlete came to me a couple days after an on-field incident where he felt like his knee was unstable. Before the MRI, I initially thought ACL tear because of how much anterior translation I felt with a Lachman. The catch? Look at where the tibia starts. With a PCL tear, the tibia can sit posteriorly. So when performing a Lachman, it can appear that there’s excessive anterior translation when you’re actually bringing the tibia from a posterior position back toward neutral. 👉 Use the medial femoral condyle and medial tibial condyle as landmarks to appreciate where the tibia is sitting before you start testing. The MRI ultimately showed a PCL tear, and it was a great reminder of two things: Mechanism matters — and don’t just assess how far the tibia moves. Assess where it starts.
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🔸 Cleared—now what? 🔸 . “Cleared” doesn’t always mean fully prepared—and it definitely doesn’t mean the work is over. Being medically cleared by a physician and demonstrating physical readiness through comprehensive objective testing are not the same thing. Too many athletes jump straight back into full practices and games with no plan, progression, or structure. Then they stop lifting because they think rehab is over. I’ve retested athletes only a couple of months after returning to play and watched their numbers fall back below 90%. These are athletes who are still lifting—so imagine what can happen when someone stops completely. What about the athlete who never truly reached 90% in the first place? ACL reinjury is multifactorial, but returning without a gradual plan and abandoning regular strength training are two preventable factors we can address. I approach return to sport by progressing one variable at a time: ▪️ Establish a baseline of movement capacity
▪️ Introduce sport-specific skill work (I outsource this)
▪️ Progress into non-contact practice
▪️ Add controlled contact once testing supports it
▪️ Gradually increase reps, minutes, intensity, practice frequency, and contact exposure based on how the athlete tests and responds Strength training continues throughout the entire process. Return gradually. Keep lifting. Clearance is not the finish line. Comment “ACL” below if you need help navigating your recovery and return to sport. . —- #ACLRehab #ACLRecovery #KneeRehab #KneeStrength #QuadStrength
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😈 Details Instagram is a great place to take a look behind the curtain at what we do But understanding the “why” behind our interventions is key Nothing is by accident. 🎥 this athlete is recovering from ankle reconstruction and is having range of motion limitations. These restrictions are causing issues up the chain…as most issues in the lower leg often do Elevating the heels is a great work around. But it doesn’t fix the mechanical, motor, and nueromuscular blocks for the athlete. The foam roller lets you see that even though he is accessing better positions, he is still being pushed back out of his ankle. If we ignore this, the pattern will stick. Even after he gains range of motion, he’ll have learned to squat, lunge, or gain depth through other areas other than his ankles. Athletes will find a way to complete a task. And the better the athlete, the better the compensator. These compensations can cause leaks in the system preventing gains in the gym, performance on the field, or worse…leave them vulnerable to injury. 🧠 don’t guess. Find a rehab plan catered to you. 👇 COMMENT below if you like this post! 🤙 FOLLOW for more tips!! ———————————————- 𝙀𝘼𝙍𝙉 𝙔𝙊𝙐𝙍 𝙋𝙍𝙊𝙂𝙍𝙀𝙎𝙎𝙄𝙊𝙉𝙎.
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We’re all pissed. The patient. The professional. Healthcare professionals have taken to social media recently to vent about patient cancellations. I get it. But I wanted to dive a bit deeper now that I’ve been doing this for a long time… my thoughts have evolved and I’m not ready to simply blame the patient… Healthcare is a business. A big one. A really really big one. It’s a wheel rolling downhill hill and we’re both caught in its momentum. Insurance based clinics are being run by people that don’t have a finger on the pulse of the operations of a PT clinic. Your care is dictated by a 3rd party provider. And we’re forced to play catch up and attempt to hit this moving target of a “productivity standard”. The companies productivity comes at the sacrifice of patient outcomes. Physical therapists are incentivized to see more patients. Salaries are…laughable. But that’s a different convo. To make up for it, companies offer volume based incentives. Meaning you get paid more if you see more patients. ⭐️ Not outcomes. You don’t get paid more for being a better PT. You get paid more for reinforcing the wheel. So it puts pressure on PTs. Do I sacrifice myself financially for my patients or do i sacrifice quality care to make ends meet (and no it still isn’t enough). As you can see, this subject has layers to it. The cash based system was my solution. Everyone benefited. Patients and physical therapist felt valued. ❓are you a PT in a busy insurance based practice? 👇 what’s your biggest hurdle to creating value?? ❓ are you a patient? 👇 have you felt this poor patient experience? Did it contribute to you feeling as though PT wasn’t important?? ❓ are you a cashed based provider? 👇 what’s biggest difference in your clinic now that you get to dictate the patient experience? People need to hear these conversations. So let’s chat🙏
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Being a PT is so much more than what a lot of people think I build relationships, help my patients through hard times, celebrate their wins, empathize with them during the hard times, push them even when they think they can’t, build them up, get them strong & confident, make them believe in themselves, & help get the@lm back to what they love More than anything, I’m their biggest cheerleader & hype squad. #physicaltherapist #sportsrehab #injury #physicaltherapy
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💥𝐃𝐚𝐲 𝐈𝐧 𝐓𝐡𝐞 𝐋𝐢𝐟𝐞 𝐎𝐟 𝐀 𝐒𝐩𝐨𝐫𝐭𝐬 𝐏𝐓 - summer edition💥 🙋‍♂️Here is day in the life video during my busy season. 🏋🏼‍♂️ 9 patients is a busy day of me but these days fly by when you work with great patients. 🙋‍♂️ 𝐋𝐞𝐚𝐯𝐞 𝐚 𝐜𝐨𝐦𝐦𝐞𝐧𝐭 𝐰𝐢𝐭𝐡 𝐚𝐧𝐲 𝐪𝐮𝐞𝐬𝐭𝐢𝐨𝐧𝐬! 👉 𝐏𝐥𝐞𝐚𝐬𝐞 𝐒𝐇𝐀𝐑𝐄 & 𝐋𝐈𝐊𝐄 𝐭𝐡𝐞 𝐩𝐨𝐬𝐭! #physicaltherapy #doctorofphysicaltherapy #dpt #athletictrainer #dptstudent
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Into the storm Avoidance behavior is known to contribute to back pain. This mentality is rooted in the belief : “if I don’t stress my back, I won’t hurt it” 🛌 We tried that. For decades doctors prescribed bed rest. Which made it worst. Then we promoted movement which helped - but patients were left with this “now what?” The only rational thing to do after an injury is to protect it. But continued protection came at a long term sacrifice of strength and stability. 🎥 The Biering-Sorenson test was used to test the back extensor endurance of people with and without histories of low back pain Studies have shown that people with history of low back pain have significantly lower hold times than people without low back pain. They found that a rough clinical guideline is : 🚩 < 60 seconds: markedly reduced endurance 60–120 seconds: below average 120–180 seconds: moderate 180+ seconds: generally good endurance 240+ seconds: excellent endurance Is this predictive of back pain? No. Back pain is very complicated. And VERY multifactorial… But here is where this research can be applicable to YOU ☝️ one of those contributors is back extensor strength. Do people with strong backs hurt their back? Yea like I said it’s complicated. BUT people with weaker backs get hurt at a markedly higher rate Other variables of back pain are really hard to assess, address, scale, progress, and re-assess ✅ but this is EASY, minimal equipment, can be done by yourself, And the results are easy to interpret Our goal should be to look more like our uninjured populations. We have similar markers and “normative values” for things like 👊Grip strength ⚖️Single leg balance 🦿Quadriceps strength - body weight : torque ratios We’re trying to be more PRO active with our medicine. Allowing patients to establish baselines that are objective and informative. We’ve got plenty of regressions to build you up to this. You might not step right into this on day 1. 𝙀𝘼𝙍𝙉 𝙔𝙊𝙐𝙍 𝙋𝙍𝙊𝙂𝙍𝙀𝙎𝙎𝙄𝙊𝙉𝙎. 😱 does this exercise scare you?? Drop a comment below let’s chat through it!
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Nobody talks about how hard this transition is. How hard it is to go from being an elite athlete, having built in best friends, playing the sport you love always, having an ultimate hype squad for running, lifting, etc to it just not being there anymore. To life beyond sports. A job. Working out alone. Working out without the goal being to perform your sport at the top level. It can feel sad & alone. Losing a piece of yourself that you had for so long and trying to find the new version of you It’s ok to feel lost and sad. But remember that little girl is so proud of you for what you’ve done and who you’ve become ❣️🫶
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⚡️E-STIM Electrical stimulation for pain management has been around forever. A helpful pain modulator, Transcutaneous Electrical Stimulation (aka TENS) utilizes the “gate theory” Pain is perceived through a feedback loop from tissue to brain. The gate theory looks to close one “gate” and open a new one - altering the sensation the brain feels providing immediate but short term decrease in pain. 🤕 ever bump your head?? You rub it immediately don’t you… Congrats, you’ve experienced the “gate theory”. Feels better when you rub it right? Hurts when you stop right? So you keep rubbing it… sometimes that helps… it’s not resolving the bump or bruise. But helpful nonetheless So it’s been shown to be at best slightly effective for our folks dealing with severe pain, unable tolerate movement. 🙂Sometimes, that’s enough. Patients can stand or sit longer, do dishes or laundry with less pain… But for an athlete, there is a big gap between decreasing initial pain and returning to sport. We HAVE to get you off the table. And now that your feeling better, it’s time to progress 🙌💪 But just when we’re getting into the fun stuff… that symptom rears its ugly head. We regress, modify, workaround, re-introduce - we get adaptation, we progress 👉 this all takes time and can be discouraging for the arhlete ⚡️ Direct current using @nerveotx looks to bridge this gap in care, speeding the re-integration of previously painful movement patterns. 🔋The constant stim allows the tissue to adapt in real time establishing mind-muscle connections that were previously painful, inhibited or blocked because of lingering irritation or even compensations. 🙏 I’ve been using this technology for years and has been a cheat code for a lot of my clients ⁉️ wanna try it? Shoot me a message, if you’re in the New Jersey area let’s meet up for a session!! If you’re a clinician and have some questions about implementing it in your practice 👇 comment below!
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Day in the life Here is a sneak peak at your standard run of the mill physical therapy schedule. Mostly older adults, mostly sedentary, mostly chronic pain. I’m 2 months into this temporary contract and so far so good. Busy yes. Ideal? No. But I’m still networking and getting to know our new area in efforts to open our East coast location of @coast2coast_pt I’ve already made great connections and have been working with some young athletes in there area outside of the busy clinic As a PT who has been on both sides of the rehab world 🛞 busy in network system 🤝 concierge 1:1 PT I find that it’s important to show this side of the coin. I’m not here to bash in network providers. I’m here to educate the consumer, you 🫵 This is what your PT is up against when you come in for your session. 🤹‍♀️ juggling multiple patients 🤔 bouncing back n forth from a variety of diagnoses 👫 dividing attention amongst other patients that may require more hands on help than you… So if you’re a young athlete having pain with deep squats, running, or looking to return to something high level… you need to be prepared for the barriers to your success. But there is something better out there for you. ⭐️ catered to you and your goals ⭐️ no hoops ⭐️ no back ended bills or collections ⭐️ just the attention and care you deserve 🙏 if you’re stuck in your rehab, reach out. 🤷🏼‍♂️ if you feel like you’re spinning your wheels, reach out. 😩 don’t even know where to start? Reach out 🤙 Your PTs are out here fighting a broken system for you. 💻 comment below if your an in network provider! ❓ what’s your biggest hurdle to patient success?? 💻 comment below if your a patient! ❓ are you happy with your PT?? Where are you stuck?!
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