Why Preventative Care Beats Reactive Treatment

Elite Performance Clinic • December 2025

Most people wait until something hurts to seek help. But what if you could prevent the injury, surgery, or chronic pain before it ever started?

Preventative care isn't just a buzzword—it's a fundamental shift in how we think about health. Instead of treating problems after they occur, preventative care identifies and addresses risk factors before they become injuries. At Elite Performance Clinic, we combine clinical expertise with performance training to keep you moving at your best for life.

What Is Preventative Care in Physical Medicine?

Preventative care means using movement assessments, manual therapy, and targeted training to identify and correct dysfunction before it causes pain or injury. It's proactive rather than reactive.

The shift: Instead of waiting for your knee to hurt, we identify hip weakness and ankle stiffness that would eventually cause knee pain—then we fix them before symptoms appear.

This approach catches problems early when they're easiest to correct, before compensation patterns become ingrained and tissue damage occurs.

Why Prevention Matters More Than You Think

Avoid Surgery and Chronic Pain
Many orthopedic surgeries are preceded by years of ignored warning signs—knee clicking, low back stiffness, shoulder tightness. Addressing these early can prevent the progression to degeneration and surgical intervention.

Real scenario: A runner with early signs of IT band syndrome can correct hip weakness and running mechanics in 4-6 weeks of targeted work. Ignore it, and you're looking at months off running and potential structural damage.

Improve Performance in Sport and Life
Preventative care isn't just about avoiding injury—it's about performing better. Correcting movement restrictions and building balanced strength allows you to lift heavier, run faster, and move more efficiently. Small improvements in mobility and stability compound over time into significant performance gains.

Increase Longevity and Quality of Life
The ability to squat, hinge, push, pull, and carry without pain determines your independence as you age. Maintaining these movement patterns through preventative care keeps you functional well into your later decades. The goal isn't just to live longer—it's to live better.

Save Time and Money
Reactive care is expensive—surgeries, extended rehab, lost training time, and reduced quality of life all add up. A knee replacement costs $30,000-$50,000 and requires 6-12 months of recovery. Investing in preventative care early costs a fraction of what you'll spend treating advanced conditions.

How Personal Training Fits Into Preventative Care

At EPC, our personal trainers work directly with our clinical team. This means your training program isn't just about aesthetics or performance—it's informed by your movement quality, injury history, and long-term health goals.

The EPC model: Your physical therapist identifies movement restrictions and corrects them through manual therapy and rehab exercises. Then, your personal trainer reinforces those corrections through progressive strength training that builds resilience and capacity.

This integrated approach ensures that you're not just strong—you're strong in the right ways, with movement patterns that protect your joints and optimize performance.

What a Preventative Care Plan Looks Like at EPC

• Initial movement assessment to identify risk factors and asymmetries
• Manual therapy sessions to address tissue restrictions and joint mobility
• Corrective exercise programming to rebuild foundational movement patterns
• Transition to performance training with a personal trainer who understands your clinical history
• Ongoing quarterly check-ins to monitor progress and adjust programming as needed

The Bottom Line

Waiting until something breaks is not a strategy. Preventative care allows you to stay ahead of injury, perform at your best, and maintain independence as you age.

At Elite Performance Clinic, we don't just treat pain—we help you build a body that's resilient, strong, and capable of handling whatever life throws at it.

Ready to invest in your long-term health? Let's build a preventative care plan that keeps you moving for life.

Call (818) 646-0040 Book Assessment

Key Movement Patterns That Prevent Injury

Elite Performance Clinic • December 2025

Understanding which movements break down first and why certain muscles become insufficient is the key to staying injury-free for life.

Most injuries don't happen suddenly—they're the result of years of faulty movement patterns and muscle imbalances that finally reach a breaking point. At Elite Performance Clinic, we identify these patterns early and correct them before they cause pain or dysfunction.

The Four Foundational Movement Patterns

Every functional human movement falls into one of four categories: squat, hinge, push, and pull. When these patterns break down, compensations develop that eventually lead to injury.

The principle: Your body will complete the movement you're attempting by any means necessary. If the correct muscles can't do the job, other muscles and joints will compensate—often with disastrous long-term consequences.

Pattern 1: The Squat

The squat pattern governs how you sit, stand, and absorb force through your lower body. When it breaks down, knees, hips, and lower back pay the price.

Weak glute medius and maximus create knee valgus—knees caving in—which increases ACL injury risk and causes patellofemoral pain. Poor ankle dorsiflexion forces excessive forward knee travel and shifts load to the low back.

The injury cascade: Weak glutes → knee valgus → increased ACL stress → meniscus wear → chronic knee pain → eventual surgery. This progression takes years but is entirely preventable.

Corrective movements include goblet squats with pause at bottom, banded squats to activate glute medius, ankle mobility drills, and single-leg box squats to identify asymmetries.

Pattern 2: The Hinge

The hinge pattern controls how you bend, lift, and produce power. This is where most low back injuries originate—not because the back is weak, but because the hips aren't doing their job.

Weak or inhibited hamstrings shift the load to the lumbar spine during lifting and running. Underactive glutes fail to extend the hip properly, forcing excessive lumbar extension.

The injury cascade: Weak posterior chain → excessive lumbar flexion when bending → disc stress → facet joint irritation → chronic low back pain → loss of hip mobility → surgery or permanent dysfunction.

Corrective movements include Romanian deadlifts, single-leg RDLs, glute bridges and hip thrusts, and deadbugs for anti-extension core control.

Pattern 3: The Push

Pushing movements require coordinated scapular control and rotator cuff stability. When these break down, shoulder impingement and chronic pain follow.

Weak serratus anterior causes scapular winging and shoulder impingement. Overactive upper traps and underactive lower traps create shoulder elevation during pressing.

The injury cascade: Poor scapular control → shoulder impingement → rotator cuff irritation → compensatory neck tension → chronic shoulder pain → labral tears or rotator cuff surgery.

Corrective movements include wall slides and floor slides, push-up plus to activate serratus anterior, banded face pulls, and thoracic spine mobility drills.

Pattern 4: The Pull

Pulling patterns maintain shoulder health and postural integrity. Modern desk work destroys this pattern, creating rounded shoulders and weak upper backs.

Weak rhomboids and mid-traps allow scapular protraction and forward head posture. Underactive lats eliminate shoulder stability during overhead movements.

The injury cascade: Weak posterior shoulder → forward head posture → neck strain → shoulder impingement → reduced overhead capacity → chronic upper body dysfunction.

Corrective movements include rows in all variations, banded pull-aparts, dead hangs and pull-up progressions, and prone T-Y-W exercises.

The Assessment Process at EPC

• Deep squat pattern with overhead reach for mobility and stability
• Single-leg stance for balance and hip control
• Hip hinge mechanics under load
• Shoulder mobility in all planes of motion
• Core stability and anti-rotation capacity
• Asymmetries between left and right sides

The Bottom Line

Your body moves in patterns, not individual muscles. When foundational patterns are clean and muscles fire correctly, you stay healthy. When they break down, injury is inevitable.

At Elite Performance Clinic, we don't wait for pain to appear. We identify faulty patterns early, correct muscle insufficiencies, and build movement quality that lasts.

Ready to identify and fix your movement patterns before they cause injury?

Call (818) 646-0040 Book Movement Assessment

Shockwave Therapy: What It Is and How It Heals

Elite Performance Clinic • December 2025

Piezoelectric shockwave therapy accelerates healing in chronic tendon and soft tissue conditions. Here's how this technology works and what it treats.

Shockwave therapy delivers high-energy acoustic waves to injured tissue, triggering a cascade of biological responses that accelerate healing. At Elite Performance Clinic, we use piezoelectric shockwave technology to treat chronic conditions that haven't responded to traditional physical therapy.

How Shockwave Therapy Works

The device generates acoustic waves that penetrate deep into tissue, creating microtrauma at the cellular level. This controlled damage triggers your body's natural healing response—increased blood flow, growth factor release, and collagen production.

The mechanism: Shockwaves break up calcifications, stimulate stem cell activity, and promote neovascularization (new blood vessel formation) in damaged tendons and soft tissue. The result is accelerated tissue regeneration and pain reduction.

Unlike ultrasound, which uses continuous sound waves, shockwave therapy delivers intense, focused pulses that create mechanical stress strong enough to restart stalled healing processes in chronic injuries.

What Conditions Respond Best

Shockwave therapy is particularly effective for chronic tendinopathies that have been present for months or years. The most common applications include plantar fasciitis, Achilles tendinopathy, patellar tendinopathy (jumper's knee), lateral epicondylitis (tennis elbow), and rotator cuff tendinopathy.

Chronic conditions: If you've had heel pain for six months and haven't seen improvement with stretching, orthotics, and rest, shockwave therapy can restart the healing process by triggering fresh inflammation and tissue remodeling.

Research shows success rates of 60-80% for chronic tendinopathies, with many patients experiencing significant pain reduction and functional improvement after a treatment series.

The Treatment Protocol

Standard protocol is 3-5 sessions spaced one week apart. Each session lasts 5-10 minutes depending on the treatment area. The shockwave applicator is placed directly on the injured tissue and delivers 2,000-4,000 pulses per session.

The treatment is uncomfortable but tolerable. You'll feel a deep, pulsing pressure at the treatment site. Some patients describe it as intense but not unbearable. The discomfort subsides immediately when the treatment stops.

Recovery timeline: You may experience increased soreness for 24-48 hours post-treatment as the healing response activates. Avoid anti-inflammatory medications during treatment, as they can interfere with the inflammatory healing process. Most patients notice improvement 4-6 weeks after completing the series.

Why It Works When Other Treatments Haven't

Chronic tendon injuries often get stuck in a failed healing cycle. The tissue is damaged but not inflamed enough to trigger repair. Traditional rest and anti-inflammatory approaches don't work because there's no active healing happening.

Shockwave therapy essentially "reboots" the healing process by creating controlled microtrauma. This restarts inflammation in a productive way, bringing fresh blood flow and growth factors to the area. Combined with progressive loading exercises, this creates an environment where true healing can occur.

How We Integrate Shockwave at EPC

• Combined with eccentric loading exercises for tendinopathy rehabilitation
• Part of comprehensive plantar fasciitis treatment protocols
• Used alongside manual therapy to break up adhesions and scar tissue
• Integrated with movement correction to address underlying biomechanical causes
• Applied to calcific deposits in tendons to promote breakdown and resorption

The Bottom Line

Shockwave therapy is a powerful tool for chronic soft tissue and tendon conditions that haven't responded to conservative treatment. It's not a first-line intervention, but for stubborn cases, it can be transformative.

At Elite Performance Clinic, we don't use shockwave in isolation. It's most effective when combined with manual therapy, corrective exercise, and progressive loading that addresses the root cause of the injury.

Dealing with chronic tendon pain that won't heal? Shockwave therapy might be the solution.

Call (818) 646-0040 Book Assessment

The Science of Contrast Therapy

Elite Performance Clinic • December 2025

Alternating hot and cold exposure isn't just a recovery trend. It's a scientifically-backed method for accelerating healing and optimizing performance.

Contrast therapy uses alternating exposure to hot and cold temperatures to manipulate blood flow, reduce inflammation, and enhance recovery. At Elite Performance Clinic, we use evidence-based protocols to maximize the therapeutic benefits of this powerful modality.

How Contrast Therapy Works

When you immerse a body part in cold water, blood vessels constrict, pushing blood away from the extremities toward the core. When you switch to the sauna, vessels dilate, flooding the area with fresh, oxygenated blood.

The mechanism: This repeated cycle creates a pumping effect that flushes metabolic waste products, delivers nutrients and oxygen to tissues, and reduces local inflammation—all without putting mechanical stress on injured areas.

Why It Matters for Recovery

Research shows contrast therapy reduces delayed onset muscle soreness and speeds recovery between training sessions. Athletes using contrast therapy report decreased muscle fatigue and improved readiness for subsequent workouts.

Post-injury or post-surgery, contrast therapy helps manage acute inflammation without completely blocking the body's natural healing response. The alternating temperatures reduce excess swelling while maintaining healthy inflammatory signals needed for tissue repair.

Clinical application: We use contrast therapy extensively in post-surgical rehab to manage swelling and maintain joint mobility during the early healing phases when traditional exercise would be too aggressive.

The Protocol That Actually Works

The effectiveness of contrast therapy depends on proper execution. Random hot-cold exposure won't give you the results you're looking for.

Cold water should be 40-60°F, Sauna 120-140°F. The standard protocol is 3-4 minutes hot, 1 minute cold, repeated for 3-5 cycles. Always end on cold to reduce final inflammation and close with vasoconstriction.

Frequency: Use 3-5 times per week for chronic conditions, daily for acute post-training recovery. Total session time should be 15-20 minutes.

For lower body recovery, contrast baths work well for ankles, knees, and feet. For upper body, contrast showers or localized immersion can be effective.

When to Use It (and When Not To)

Contrast therapy is powerful, but it's not appropriate for every situation. Timing matters.

Best applications include post-training recovery for athletes with high training volume, subacute injuries 3-7 days post-injury when acute inflammation is settling, chronic conditions like tendinopathy or arthritis, and post-surgical rehabilitation once cleared by your surgeon.

Important: Do not use contrast therapy in the first 48-72 hours after acute injury. During this acute phase, ice alone is more appropriate to control initial inflammation.

Avoid contrast therapy if you have peripheral vascular disease, Raynaud's disease, uncontrolled hypertension, open wounds or infections, or impaired temperature sensation.

How We Use Contrast Therapy at EPC

• Post-surgical swelling management in weeks 2-6 of recovery
• Between training sessions for high-volume athletes
• Chronic tendinopathy treatment combined with eccentric loading
• Arthritis flare management to reduce joint inflammation
• Pre-performance preparation to increase tissue temperature and blood flow

The Bottom Line

Contrast therapy is a low-risk, evidence-backed recovery tool that enhances circulation, reduces inflammation, and accelerates healing when used correctly.

At Elite Performance Clinic, we integrate contrast therapy into comprehensive recovery programs for both injured patients and high-performing athletes. It's one tool in a larger toolkit; most effective when combined with manual therapy, movement correction, and progressive loading.

Want to optimize your recovery with evidence-based protocols?

Call (818) 646-0040 Book Consultation

5 Signs You Need Physical Therapy Before Surgery (Not After)

Elite Performance Clinic • December 2025

Most people think of physical therapy as something that happens after surgery. But what if we told you that the right PT program before your procedure could actually improve your surgical outcome?

Pre-operative physical therapy, also called "prehabilitation," is gaining recognition among orthopedic surgeons for good reason. Here's why preparing your body before surgery might be the most important step in your recovery plan.

1. You Have Limited Range of Motion

If your joint mobility is already compromised before surgery, you're starting your recovery from a deficit. Pre-surgical PT helps restore as much range of motion as possible, giving your surgeon better access during the procedure and giving you a head start on post-op recovery.

Example: A patient scheduled for knee replacement with only 90 degrees of flexion will have a harder recovery than one who enters surgery with 110 degrees. Those 20 degrees matter.

2. Your Surrounding Muscles Are Weak or Atrophied

Surgery creates trauma to tissue. If the muscles supporting your surgical site are already weak, they'll struggle to protect and stabilize the area during healing. Strengthening these muscles beforehand reduces compensation patterns and speeds up your return to function.

Research shows: Patients who complete prehab programs often reduce their post-operative physical therapy time by 30-40%.

3. You're Experiencing Chronic Inflammation

Entering surgery with high levels of inflammation can complicate healing and increase post-surgical pain. A targeted PT program that includes manual therapy, movement modification, and specific exercises can help reduce inflammatory markers before your procedure.

4. You Don't Understand Your Post-Op Restrictions

Many patients leave their surgical consultation unclear about what they can and can't do after surgery. Pre-operative PT gives you a chance to learn these restrictions, practice exercises you'll need post-op, and ask questions in a less stressful environment than your first week of recovery.

5. You Want to Return to High-Level Activity

If your goal is to get back to competitive sports, intense training, or physically demanding work, prehabilitation is essential. Building a strong foundation pre-surgery creates better tissue quality for healing and establishes movement patterns that will carry through your recovery.

What Does Pre-Surgical PT Look Like?

At Elite Performance Clinic, our prehabilitation programs are designed in collaboration with your surgical team and typically include:

• Manual therapy to improve tissue quality and reduce pain
• Targeted strengthening of muscles that will support your recovery
• Range of motion work to optimize surgical access
• Education on post-operative expectations and restrictions
• Baseline measurements to track your progress after surgery

The Bottom Line

Surgery is just one part of your recovery journey. The stronger and more prepared you are going in, the better your outcome will be coming out.

If you're scheduled for an orthopedic procedure and haven't discussed prehabilitation with your surgeon, it's worth asking. Many physicians are now recommending 4-6 weeks of targeted PT before surgery for their patients.

At Elite Performance Clinic, we work closely with orthopedic surgeons throughout Los Angeles to provide evidence-based prehabilitation programs.

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