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
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