Simply put, therapy makes something that isn’t working, work again. Performance, on the other hand, makes something that already works, work better. There is overlap between the two realms, but it’s not as large as many seem to think. If you understand how to fix a torn muscle, you likely have a basic understanding of how to maximize performance of a normal muscle. Likewise, if you understand how to make a normal heart become more efficient, you’ll have modest knowledge of what happens when something goes wrong.
Having been a relatively high-level athlete myself, I am comfortable in the world of performance (fitness and sport performance). However, that is not my expertise. As I value expertise, I advise people within my area of expertise (orthopedic therapy) and refer people to other professionals for guidance in other fields.
Do you run a 9-minute mile and want to run a 6-minute mile in 3 months? Do you want to improve your vertical leap by 25% before next season? My role in these situations is to ensure no orthopedic problem is stopping you (which is an important step!). That it, things work well, they are just not conditioned for that higher level of performance. While I could certainly help in the performance realm, if you want the best, most efficient training plan, I am not your person.
Overlap most concretely occurs when a high-performing patient is nearing the end of therapy. My job is to restore a patient’s body to the patient’s individual normal. If her normal is playing professional soccer and I can get her only 75% of the way there (at which point her body is way above universal norms), that is the time for a performance specialist to take the lead to get her to 100%. -- Laura
When discussing athletic performance, we think of coaches, strength and conditioning specialists, trainers, and so on, but my role comprises the foundation. Power, balance, and mobility are certainly trainable, but if your body is not fully normal to begin with, training will only get you so far. If performance prowess is your goal, you need normal nerve conduction, nerve extensibility, strength, mobility, biomechanics, etc. first. (Having no symptoms doesn’t mean everything is functioning normally.)
Consider jumping. If there’s even a slight derangement (painful or not) in the lumbosacral spine, the electricity supplying necessary muscles can be impeded. Tiny malalignments in the foot, ankle, knee, hip, or spine joints can affect strength, mobility, balance, and movement patterns with jumping. Abnormalities with muscles or tendons themselves (rare) will also impact jumping.
My expertise is in ensuring people have normal physiology before they go train to make it exceptional. (There are, of course, some allowances.) Perhaps most importantly, I teach people how to self-assess and self-treat so they can always perform with optimized physiology. It takes only minutes. I believe that many “off” days are due to minor, transient joint malalignments - which can easily be self-detected and corrected if you learn how. --Laura
Find more information about the world of diagnosing and treating orthopedics here!