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# Breakthrough Performance & Wellness: Breakthrough Performance and Wellness is redefining the role of physical therapy in the lives of active people. We are an essential line of treatment to recover quickly and thoroughly.

## Sitemaps
[XML Sitemap](https://breakthroughperformanceavl.com/sitemap_index.xml): Includes all crawlable and indexable pages.

## Posts
- [Do I Need a Doctor Referral for Physical Therapy in Asheville?](https://breakthroughperformanceavl.com/do-i-need-a-doctor-referral-for-physical-therapy-in-asheville/): Here is the good news: if you are looking for physical therapy in Asheville, NC, you do not need a doctor's referral to get started. North Carolina is a Direct Access state, which means you can walk through the door at Breakthrough Performance & Wellness and begin working with a Doctor of Physical Therapy today, no permission slip required.
- [How Do I Choose the Right Physical Therapist in Asheville?](https://breakthroughperformanceavl.com/how-do-i-choose-the-right-physical-therapist-in-asheville/): As an active person in Asheville, you know the frustration of dealing with an injury or hitting a performance plateau. You are not simply looking for pain relief. You are looking for a partner who can help you return to your sport, hobby, or active lifestyle stronger and more resilient than before. Whether you are a trail runner navigating the Blue Ridge or an athlete chasing a new personal record, your recovery deserves more than a generic exercise handout.
- [What Makes a Physical Therapy Clinic the Best in Asheville, NC?](https://breakthroughperformanceavl.com/what-makes-a-physical-therapy-clinic-the-best-in-asheville/): Are you an active individual in Asheville experiencing pain, a frustrating injury, or the feeling that you are not performing at your peak? Whether you are summiting a trail off the Blue Ridge Parkway, chasing a new PR at your local gym, or simply keeping up with your kids, your physical health is the foundation of your lifestyle.
- [Physical Therapy in Asheville: A Complete Guide to Recovery and Performance](https://breakthroughperformanceavl.com/physical-therapy-in-asheville-a-complete-guide-to-recovery-and-performance/): At Breakthrough Performance & Wellness, we understand the active spirit of Asheville because we live it too.
- [WHAT DO YOU MEAN YOU DON’T TAKE INSURANCE??](https://breakthroughperformanceavl.com/what-do-you-mean-you-dont-take-insurance/): This is my favorite question that I get on a daily basis from potential clients. I run a cash-based physical therapy practice. This means I do not accept insurance, and collect for services at the time of treatment. I elected to go this route in the summer of 2017 after spending 2 years in an insurance-based outpatient orthopedic clinic. Over that time I experienced all the highs and lows of working in a clinic of that type, from the stable income with good benefits to the extreme caseload of seeing 100 patients within a week by myself! I realized after moving into a management role that all the wonderful and idealistic things I was told in PT school as well as by my employers really weren’t holding up in the real world. I learned that our marketing was targeted towards physicians, and that it was important to push for more visits and overload the schedule over ensuring a younger physical therapist has time to grow and focus on quality patient care. I definitely had some questions about where my future was after seeing the decline of my healthcare experience into more of a mill type setting. If the start of this story sounds a bit depressing, it’s because it is. This is a growing reality among outpatient clinics in this country due to drastically increasing healthcare costs, severely reduced reimbursement, and the development of bloated giant PT companies that begin to lose touch with what’s really important….the client.
- [Overhead Mobility Clinic!](https://breakthroughperformanceavl.com/overhead-mobility-clinic/): Overhead mobility for things like squats, pull-ups, Olympic lifts, and pressing activity is massively important and very often something people struggle with. I’ll be hosting multiple events coming up at Beer City CrossFit and CrossFit Pisgah going over some easy tests and quick fixes for that overhead position. The first event will be at Beer City CrossFit on 4/26 at 5:30pm! Be sure to click the link below to find out more information and watch the video for a little preview. Come on out and fix that overhead!
- [Finding Your Glutes](https://breakthroughperformanceavl.com/finding-your-glutes/): If you’ve been a part of a CrossFit gym for any length of time, you’ve almost definitely heard someone mention glute activation, or how important it is to use your glutes while you’re lifting, squatting, etc. The other end of the spectrum here is that a large percentage of people have no clue what the heck that means or WHY it’s important. Today I wanted to cover some of the reasons why your glutes are important, how to actually be sure you’re using them effectively, and maybe most importantly exactly what people are talking about when they mention glutes.
- [Common Misconceptions About Low Back Pain (Part 2)](https://breakthroughperformanceavl.com/common-misconceptions-about-low-back-pain-part-2/): Continuing with my mini-series on low back issues I wanted to address some of the more common “myths” about the lower back and back pain. I’ve listed Part 2 of the most common myths below:
- [Common Misconceptions About Low Back Pain (Part 1)](https://breakthroughperformanceavl.com/common-misconceptions-about-low-back-pain-part-1/): Continuing with my mini-series on low back issues I wanted to address some of the more common “myths” about the lower back and back pain. The lumbar spine and its relationship to pain are very complex concepts. There is a lot of misinformation out there regarding the spine leading to a lot of fear and misunderstanding that doesn’t help anyone. Today I’ll highlight a few of the most common “myths” below:
- [3 REASONS YOU HAVE LOW BACK PAIN DURING CROSSFIT, AND HOW TO FIX IT](https://breakthroughperformanceavl.com/3-reasons-you-have-low-back-pain-during-crossfit-and-how-to-fix-it/): Low back pain is a issue among people in general with almost 20% of people between ages 20 and 59 dealing with chronic low back pain. Getting more specific into injuries within the CrossFit population, low back injuries are the most common associated with powerlifting movements, and the second most common injury overall behind shoulders. Interestingly enough, low back pain occurs similarly in both active and inactive populations. There are a lot of reasons for that which we won’t get into much in this post, but it mostly centers around the cause of low back pain being much more complicated than a simple musculoskeletal cause. For the sake of keeping it simple today, I’m going to highlight 3 main causes of low back pain in athletes participating in CrossFit, and a few basic fixes.

## Pages
- [Expert Shoulder Pain Treatment in Asheville, NC](https://breakthroughperformanceavl.com/shoulder-pain-asheville-nc/): Shoulder pain is keeping you from the trails, the gym, and the life you love. At Breakthrough Performance Physical Therapy, our Doctors of Physical Therapy deliver one-on-one care built around the root cause of your pain — not a temporary fix. Most patients feel relief after their very first session. No referral needed. Book your appointment today.
- [Top-Rated Sports Physical Therapy in Asheville, NC](https://breakthroughperformanceavl.com/sports-physical-therapy-asheville-nc/): Whether you're a trail runner, weekend warrior, or competitive athlete, Breakthrough Performance Physical Therapy helps you recover faster, move better, and get back to doing what you love. Every session is one-on-one with a Doctor of Physical Therapy — no aides, no shortcuts. No referral needed. Start with a free 20-minute phone consult.
- [Scott Keffer](https://breakthroughperformanceavl.com/staff/scott-keffer/): .
- [Terms of Service](https://breakthroughperformanceavl.com/terms-of-service/): Breakthrough Performance and Wellness, LLC
- [Expert Knee Pain Treatment in Asheville, NC](https://breakthroughperformanceavl.com/knee-pain-asheville-nc/): You shouldn't have to give up hiking, running, or the activities you love because of knee pain. At Breakthrough Performance Physical Therapy in Asheville, you get one-on-one care with a Doctor of PT — no referrals, no aides, no cookie-cutter plans.
- [Expert Back Pain Relief in Asheville, NC](https://breakthroughperformanceavl.com/back-pain-asheville-nc/): You deserve more than a temporary fix. At Breakthrough Performance Physical Therapy, our Doctors of Physical Therapy deliver one-on-one care designed to find the root cause of your back pain — and get you back to the mountain lifestyle you love. No referral needed. Most patients experience significant relief in 6 visits or less. Serving active adults, athletes, and desk workers throughout Asheville and Buncombe County.
- [Expert Physical Therapy in Asheville, NC](https://breakthroughperformanceavl.com/physical-therapy-asheville-nc/): Get back to the active mountain lifestyle you love with personalized, one-on-one care from licensed Doctors of Physical Therapy—no referral needed.
- [Tendinitis in Asheville, NC](https://breakthroughperformanceavl.com/what-we-treat/tendinitis/): Tendinitis, also known as tendonitis, is a condition that can happen when a tendon in your body becomes inflamed or irritated. Tendons are strong bands that attach your muscles to your bones. When they get swollen or irritated, it can cause pain and discomfort.
- [ACL Tear in Asheville, NC](https://breakthroughperformanceavl.com/what-we-treat/acl-tear/): An ACL tear is an injury that happens to a part of your knee called the anterior cruciate ligament, or ACL for short. Your ACL is like a strong, stretchy band that helps keep your knee stable when you move it. When it tears, it can cause pain and make it hard to do activities like running and jumping.
- [Thoracic Outlet Syndrome (TOS) in Asheville, NC](https://breakthroughperformanceavl.com/what-we-treat/thoracic-outlet-syndrome/): Thoracic Outlet Syndrome (TOS) is a condition that can cause pain, numbness, and tingling sensations in your neck, shoulder, and arm. It happens when there's pressure on the nerves and blood vessels that pass through a narrow space between your collarbone and first rib, known as the thoracic outlet.
- [Rotator Cuff Tears in Asheville, NC](https://breakthroughperformanceavl.com/what-we-treat/rotator-cuff-tears/): A rotator cuff tear is a common shoulder injury that affects the muscles and tendons around the shoulder joint. These muscles and tendons form the rotator cuff, which helps you move your arm and shoulder. When one or more of these tendons become torn, it can cause pain and limit your ability to use your shoulder properly.
- [Hip Replacement Surgery in Asheville, NC](https://breakthroughperformanceavl.com/what-we-treat/hip-replacement-surgery/): Hip replacement surgery is a medical procedure that helps people with severe hip pain and limited mobility regain their quality of life. During this surgery, a surgeon replaces the damaged or worn-out hip joint with artificial components made of metal, plastic, or ceramic. This new hip joint helps improve mobility, reduce pain, and allow individuals to engage in daily activities comfortably.
- [Knee Replacement Surgery in Asheville, NC](https://breakthroughperformanceavl.com/what-we-treat/knee-replacement-surgery/): Knee replacement surgery is a medical procedure that helps people who have severe knee pain and limited mobility due to damaged knee joints. During this surgery, a doctor replaces the damaged parts of the knee with artificial components made of metal and plastic. This new joint helps restore function and reduce pain, allowing individuals to enjoy an active lifestyle once again.
- [Balance and Gait Disorders in Asheville, NC](https://breakthroughperformanceavl.com/what-we-treat/balance-and-gait-disorders/): Balance and gait disorders are conditions that affect a person's ability to stand and walk steadily. These disorders can make simple tasks like walking, climbing stairs, or getting up from a chair challenging. Balance and gait are essential for our everyday activities, and when they are impaired, it can lead to accidents and injuries.
- [Plantar Fascitis in Asheville, NC](https://breakthroughperformanceavl.com/what-we-treat/plantar-fascitis/): Plantar Fasciitis is a common problem that can cause pain in your feet. It happens when a part of your foot called the plantar fascia gets irritated and inflamed. The plantar fascia is a long, thick band of tissue that runs along the bottom of your foot.
- [Headaches in Asheville, NC](https://breakthroughperformanceavl.com/what-we-treat/headaches/): Headaches can be caused by a variety of factors, including stress, tension, poor posture, and muscle weakness. While medication is often the go-to solution for treating headaches, physical therapy can also be an effective way of managing headaches and reducing their frequency and severity. In this article, we will explore how physical therapy can help treat headaches and how it can be incorporated into a treatment plan.
- [Stroke in Asheville, NC](https://breakthroughperformanceavl.com/what-we-treat/stroke/): Stroke is a devastating condition that affects millions of people worldwide. It is caused by a disruption in the blood supply to the brain, which can lead to brain damage and a range of physical and cognitive symptoms. Physical therapy is an essential part of stroke treatment, as it helps patients recover their mobility, strength, and independence.
- [Parkinson’s in Asheville, NC](https://breakthroughperformanceavl.com/what-we-treat/parkinsons/): Parkinson's disease is a progressive neurodegenerative disorder that affects the central nervous system. It is characterized by tremors, rigidity, and difficulty with movement, balance, and coordination. While there is no cure for Parkinson's disease, physical therapy can help improve the patient's quality of life and slow the progression of the disease.
- [Motor Vehicle Accident in Asheville, NC](https://breakthroughperformanceavl.com/what-we-treat/motor-vehicle-accident/): Assessment and Diagnosis
- [TMJ/TMD in Asheville, NC](https://breakthroughperformanceavl.com/what-we-treat/tmj-tmd/): Multiple factors contribute to muscle tightness and dysfunction that characterize this condition. Most often, poor posture and neck alignment change the pull of the muscles that make your jaw move. This causes painful grinding and irritation of the TMJ. Other causes may include:
- [Neck Pain in Asheville, NC](https://breakthroughperformanceavl.com/what-we-treat/neck-pain/): There are many reasons neck pain can occur. Neck pain typically starts at the base of the skull and ends at the top of the shoulder blades and could settle in the back. It can be anything from a dull, constant ache to sharp, stabbing pains. Additional symptoms can include:
- [Joint Pain in Asheville, NC](https://breakthroughperformanceavl.com/what-we-treat/joint-pain/): Joint pain is a common discomfort that can affect people of all ages. It occurs when there is discomfort, soreness, or achiness in one or more of the body's joints, such as the knees, shoulders, or hips. Joint pain can be caused by various factors and conditions, and it can impact your daily life and mobility.
- [Chronic Pain in Asheville, NC](https://breakthroughperformanceavl.com/what-we-treat/chronic-pain/): We’ve all had sprained ankles and pulled back muscles. And while those incidents are never pleasant, the pain rarely lasts more than a few weeks at most. Chronic pain, on the other hand, can go on for months or even years, especially when you can’t find the proper diagnosis or treatment for it.
- [Arthritis in Asheville, NC](https://breakthroughperformanceavl.com/what-we-treat/arthritis/): In a bid to provide you with an in-depth understanding of arthritis, we've compiled comprehensive information regarding what arthritis is, its causes, symptoms, and how a professional physical therapist can help in treatment and management. At our Physical Therapy Clinic, we prioritize your wellness and are dedicated to offering tailored therapy solutions to alleviate your discomfort and improve your mobility.
- [Sports Injuries in Asheville, NC](https://breakthroughperformanceavl.com/what-we-treat/sports-injuries/): Athletes on every level run the constant risk of injury. Professional sports icons run the same risk as those on High School and college teams and weekend outdoor enthusiasts. Whatever your sport or level of achievement, the risk of injury hasn’t deterred you from pursuing your passion and won’t either. At our Physical Therapy Clinic is dedicated to helping injured athletes recover quickly and regain their full range of motion and strength.
- [Dizziness and Vertigo in Asheville, NC](https://breakthroughperformanceavl.com/what-we-treat/dizziness-and-vertigo/): Patients who often experience dizziness or vertigo need to seek medical attention. Dizziness can result from a simple change in medication, or an incorrect prescription of glasses. It could also be caused by a more serious condition such as a neurological disorder.
- [Thank You Ask A Specialist](https://breakthroughperformanceavl.com/thank-you-ask-a-specialist/): Thank you! One of our specialists will be in contact with you soon. CHECK OUT WHAT OTHERS IN Asheville and Arden ARE SAYING!
- [Thank You Contact](https://breakthroughperformanceavl.com/thank-you-contact/): Thank you! A member of our team will be in contact with you soon. CHECK OUT WHAT OTHERS IN Asheville and Arden ARE SAYING!
- [Thank You Request An Appointment](https://breakthroughperformanceavl.com/thank-you-request-an-appointment/): Thank you! A member of our team will be in contact with you to schedule your appointment as soon as possible. CHECK OUT WHAT OTHERS IN Asheville and Arden ARE SAYING!
- [Request An Appointment](https://breakthroughperformanceavl.com/request-an-appointment/): 554 Riverside Dr C,Asheville, NC 28801
- [Dan Carmack](https://breakthroughperformanceavl.com/staff/dan-carmack/): A fascination with learning how the human body work and how to make it perform even better drew me into the professional of physical therapy and ultimately to the opening of my clinic, Breakthrough Performance and Wellness in Asheville, NC.
- [Link](https://breakthroughperformanceavl.com/staff/link/): Hi, I’m Link, and I’ve been a clinic dog since January 2019. I’m an Asheville native, and when I’m not napping on clinic equipment you can usually find me wandering around the gym looking for people with treats. If I haven’t met you I may welcome you to Breakthrough with some woofing, but I warm right up in just a few minutes especially when helped by treats. I might even come sit next to you during your treatment session! In my spare time, I enjoy going out for hikes and saying hi to all the dogs at local breweries.
- [Coop](https://breakthroughperformanceavl.com/staff/coop/): Hi, I’m Coop and I've been a van lifer for my whole life, and can often be found napping somewhere cool, or taking myself for walks to find people to pet me.
- [Rachael Paszko](https://breakthroughperformanceavl.com/staff/rachael-paszko/): My journey as a physical therapist has developed greatly through the years. After graduating from Wheeling University in 2016, I spent time working in Virginia and West Virginia before falling in love with Asheville, North Carolina. I completed an orthopedic residency program in orthopedics in 2020 and became an Orthopedic Certified Specialist by the American Board of Physical Therapy Specialties (ABPTS). Since that time, I have also found my passion for treating individuals experiencing pelvic floor dysfunction. It quickly became clear to me that symptoms of urinary and fecal incontinence, frequency/urgency, pelvic pain, pain with sexual activity are under-reported and under-treated. I love empowering individuals to reclaim their confidence and help lift the feelings of isolation associated with it! I have completed extensive training to treat the pelvic health population through Herman and Wallace Pelvic Rehabilitation Institute and Institute of Clinical Excellence. 
- [Megan McCallister](https://breakthroughperformanceavl.com/staff/megan-mccallister/): Do I Need a Doctor Referral for Physical Therapy in Asheville? Do I Need a Doctor Referral for Physical Therapy in Asheville? DPT, TPI-C, Cert. DN, Physical Therapist As an Asheville native, I am excited to be back in the community that has molded me into who I am today.  I moved back to the area after completing my Doctorate in Physical Therapy at Elon University.  Physical therapy was a natural fit for me following my own athletic endeavors. Soccer was a huge part of my childhood and is still a passion of mine.  I played collegiately at Western Carolina University and continue to watch the English Premier League, glory glory Manchester United! Additionally I was a member of the inaugural women’s team with Asheville City SC in 2018.
Physical therapy has allowed me to merge my passions with my professional life.  I enjoy working with active adults who have recreational endeavors that they want to continue performing at a high level and pain free. I am certified in dry needling (Cert. DN) and use this modality with patients diagnostically and as a treatment method for motor recruitment and pain management. I believe in the importance of strength training in physical therapy and the role in plays in longevity and injury prevention. My partner Stephen and I met while at Elon University and we both work as Physical Therapists here in Western North Carolina.  On weekends, you can find us playing golf, pickleball, adult league soccer, and hanging with our tortishell cat Eevee.   Top 5 values at this time in my life: Kindness, humor, family, community, health (physical and mental) During the pandemic, I started playing golf and have loved the challenge the sport presents.  A goal of mine is to attend all 4 majors in golf at least once and eventually play at a single digit handicap.  I have a level I certification through the Titleist Performance Institute (TPI-C).  This includes a physical screen as well as reviewing swing mechanics to optimize efficiency with the golf swing with my patients. 
- [Pelvic Floor In Asheville](https://breakthroughperformanceavl.com/services/pelvic-floor/): The pelvic floor is a “sling” of muscles spanning the bowl of the pelvis and this set of structures has many connections with the core, low back, and hip musculoskeletal systems.
- [Sports Conditioning In Asheville](https://breakthroughperformanceavl.com/services/sports-conditioning/): We offer customized sports conditioning programs adjusted to specific sports and skill levels to clients who are preparing for the rigors of engaging in specific sports without incurring a high risk of injuries.
- [Dry Needling In Asheville](https://breakthroughperformanceavl.com/services/dry-needling/): Dry Needling is also known as intramuscular stimulation (IMS) and trigger point dry needling (TDN). It is a safe, effective and efficient treatment used to:
- [Physical Therapy Clinic in Arden, NC](https://breakthroughperformanceavl.com/contact-us/arden/): Our Physical Therapy practice places patients first. Our passion is to help them reduce pain or discomfort quickly through a hands-on approach that assesses and treats physical conditions that affect muscles and nerves.
- [Sports Rehabilitation In Asheville](https://breakthroughperformanceavl.com/services/sports-rehabilitation/): Whether you’re a weekend warrior or a serious athlete, sports injuries are a fact of life. A twisted ankle or an aching back can usually be treated at home. But for those breaks and tears that call for immediate medical attention, or those pains that just aren’t going away, physical therapy is often a critical part of the healing process.
- [Manual Therapy In Asheville](https://breakthroughperformanceavl.com/services/manual-therapy/): Manual therapy is a safe, effective and non-invasive treatment method that is used by physical therapists, massage therapists, and athletic trainers. Typically, patients visit a manual therapist when they are experiencing musculoskeletal pain. During treatment, your physical therapist may work to relieve pain with joint manipulation, manipulation of the muscles, joint mobilization and kneading. Through this type of physical therapy, our highly-trained and experienced manual therapist is able to implement a hands-on approach to healing that is designed to help manage chronic pain, increase your range of motion, reduce inflammation, treat joint structures and promote faster healing. If you or a loved one is experiencing musculoskeletal pain, contact our offices today to learn more about the benefits of manual therapy.
- [FAQ](https://breakthroughperformanceavl.com/faq/): If you have booked a full appointment, you can expect to receive a thorough assessment of your injury and the presentation of a recommended customized program of care.
- [Physical Therapy Clinic in Asheville, NC](https://breakthroughperformanceavl.com/contact-us/asheville/): Our Physical Therapy practice places patients first. Our passion is to help them reduce pain or discomfort quickly through a hands-on approach that assesses and treats physical conditions that affect muscles and nerves.
- [Contact Us](https://breakthroughperformanceavl.com/contact-us/): Our Physical Therapy practice places patients first. Our passion is to help them reduce pain or discomfort quickly through a hands-on approach that assesses and treats physical conditions that affect muscles and nerves.
- [Blog](https://breakthroughperformanceavl.com/blog/): Jun 22, 2026 | Blog
- [Hip & Knee Pain in Asheville, NC](https://breakthroughperformanceavl.com/what-we-treat/hip-and-knee-pain/): Your hips and knees are the largest joints in your body. While many people may experience hip pain or knee pain on their own, it is also common to experience them together as well. You may first notice hip pain on the outside area of the hip, along the outer buttock or upper thigh area. Hip pain can occur whether you are at rest, walking or during any other type of physical activity. Knee pain is another very common reason why people visit our physical therapist each day. In addition to chronic pain, other common symptoms of knee pain include stiffness, swelling popping, and general instability. Many physical therapy patients also find that it is difficult or even impossible to fully straighten the knee as well. If you are experiencing hip pain or knee pain, call our offices today to schedule a free physical therapy consultation.
- [Shoulder Pain in Asheville, NC](https://breakthroughperformanceavl.com/what-we-treat/shoulder-pain/): Does a simple move to place a jar on a high shelf seem impossible because of shoulder pain? Do you wonder whether or not you’ll able be able to sleep on your side again without waking up in agony? Has a recent injury made your shoulder all but immobile? There are many kinds of shoulder pain, ranging from the temporary discomfort of a pulled muscle to the bone-on-bone friction of arthritis. But whatever is behind your shoulder pain, you can find comfort in the fact that physical therapy offers great promise as a natural pain management modality. Contact one of our physical therapists today to find out how this form of treatment can benefit your shoulder!
- [Foot & Ankle Pain in Asheville, NC](https://breakthroughperformanceavl.com/what-we-treat/foot-or-ankle-pain/): Physical therapy has been proven to help with the rehabilitation of injured extremities, in addition to providing relief for both acute and chronic pain.
- [Elbow, Wrist & Hand Pain in Asheville, NC](https://breakthroughperformanceavl.com/what-we-treat/elbow-wrist-and-hand-pain/): Are you suffering from recurrent elbow, wrist, or hand pain that doesn’t seem to get better? There are several reasons why you may experience pain or stiffness in these areas of the body. We use our elbows, wrists, and hands for driving, preparing food, dressing and much more. As a matter of fact, we rely on these upper extremities for daily living. Contact us for information regarding how our physical therapist can reduce or completely eliminate pain in your elbows, wrists, and hands.
- [Privacy Policy](https://breakthroughperformanceavl.com/privacy-policy/): Breakthrough Performance and Wellness, LLC