Megan Peach, DPT, CSCS is an Orthopedic Clinical Specialist (OCS)

By Megan Peach, DPT, OCS, CSCS
megan@excelptmt.com

Megan Peach, physical therapist with Excel Physical Therapy of Bozeman and Manhattan, has received the advanced Orthopedic Clinical Specialist (OCS) designation after passing a rigorous exam from the American Physical Therapy Association‘s American Board of Physical Therapy Specialties. The specialist certification program provides formal recognition for physical therapists with advanced clinical knowledge, experience, and skills in a special area of practice. Congratulations Megan for achieving your ongoing advanced training (and the 3 new initials)!


What is an Orthopedic Clinical Specialist (OCS)?

Orthopedic Clinical Specialists are recognized by the American Board of Physical Therapy Specialties as individuals whose clinical specialization in orthopedic physical therapy demonstrates knowledge, skill and experience exceeding that of an entry level physical therapist. The specialist certification program was established to provide formal recognition for physical therapists with advanced clinical knowledge, experience, and skills in this special area of practice and to assist consumers and the health care community in identifying these physical therapists.

The credentials of Orthopedic Clinical Specialist (OCS) are designated to those individuals who have successfully become board certified clinical specialists in the areas of orthopedics.  At a minimum, therapists who receive this clinical distinction have completed 2,000 hours of direct patient care in the area of orthopedics and have successfully completed a rigorous written examination.

Activate Your Glutes! Here's How

By Megan Peach, DPT, OCS, CSCS
megan@excelptmt.com

Did you know?

The gluteal muscles are an important muscle group for everyday functional activities. The gluteus medius muscle acts to stabilize the pelvis during single limb activity such as going up or down stairs, balance exercises, and even walking. The gluteus maximus helps to maintain trunk control & propel the body forward during walking and running. A recent study in the February 2013 issue of the Journal of Orthopaedic and Sports Physical Therapy investigated gluteal muscle activation during specific exercises to determine which exercises were most effective in recruiting the glute medius & maximus while minimizing the recruitment of other substituting muscle groups.

This particular study found that a sidelying leg lift and side step exercise were of the top three most effective exercises for strengthening the gluteus medius, and the clamshell and single-leg bridge exercises were most effective for strengthening the gluteus maximus. Of these exercises, the clamshell, side step, and single leg bridge exercises were found to be less likely to recruit other musculature such as the tensor fascia lata (TFL).

Selkowitz DM, et al. Which exercises target the gluteal muscles while minimizing activation of the tensor fascia lata? Electromyographic assessment using fine-wire electrodes. JOSPT 2013; 43(2): 54-65

 

If you have specific questions about these exercises or would like to incorporate them into your home exercise program, please contact Megan Peach, DPT, CSCS at 406.556.0562.

Pregnancy and Exercise Tips by Megan Peach, DPT, CSCS

By Megan Peach, DPT, OCS, CSCS
megan@excelptmt.com

Just in case you missed our most recent library presentation on pregnancy & exercise, here’s a recap with some helpful tips for exercising while pregnant!

 

Pregnancy is an incredible time in a family’s life with LOTS of changes for everyone involved and LOTS of questions about the unknown. As an expectant mother myself, I realized that not a lot of guidance exists regarding exercise during pregnancy. With a little research, here’s what I found:

 

Exercise during pregnancy can be beneficial for both mother and baby, however you must check in with your prenatal care provided prior to beginning an exercise program and also regularly throughout your pregnancy to ensure the health of you and your baby. Benefits of exercise during pregnancy can include reduced risk of premature labor, reduced swelling, reduced risk of gestational diabetes & preeclampsia, decreased low back pain, and increased regularity of the digestive system.

 

The American College of Obstetrics and Gynecology recommends 30 minutes of daily exercise of moderate intensity for healthy pregnant women. Examples of moderate intensity are walking 3-4 miles per hour (15-20 minute miles), light swimming or cycling, and light resistance exercise. Can you maintain a conversation while exercising? If so, you are likely exercising at a moderate intensity.

 

Water walking or aerobic water exercise is a good option as water exercise can decrease force across joints as well as prevent an harmful rise in core temperature. Resistance and core exercises are appropriate during pregnancy provided that resistance is kept low (preferably body weight only) with high repetitions, and no sit-ups! Yoga is a great alternative to traditional core exercises although some positions may have to be modified to accommodate your growing belly and you should avoid inverted positions after 32 weeks gestation. Don’t forget the Kegels! It’s important to maintain your pelvic floor strength with kegel exercises during pregnancy to help prevent incontinence and to support the pelvic floor as it becomes stressed with the weight of the growing baby.

 

Some general advice for exercising during pregnancy:

  • Warming up and cooling down may be even more important during pregnancy than before to redistribute blood flow to working muscles in preparation for exercise.

  • Due to weight gain, changes in center of mass and balance, and hormonal fluctuations, exercise during pregnancy may feel different from exercise prior to pregnancy.

  • Listen to your body and stop if you feel discomfort! It’s important to stop exercise immediately if you experience the following signs and symptoms and contact your care provided should symptoms persist: dizziness, headache, chest pain, calf pain or swelling, bleeding, pre-term labor, amniotic fluid leakage. The farther along you are you are in your pregnancy, the more you may have to decrease the intensity and/or duration of exercise depending on your energy levels.

  • Pay attention to hydration, heat stress, fatigue, & exercise intensity as these may change from one week to the next.

Without a doubt, exercise during pregnancy has substantial benefits to mother & baby provided it is practiced safely. Please do not hesitate to contact your prenatal care provider should you have questions regarding exercise & your pregnancy!

 

Benefits of exercise during pregnancy can include reduced risk of premature labor, reduced swelling, reduced risk of gestational diabetes & preeclampsia, decreased low back pain, and increased regularity of the digestive system.

 

If you have any specific questions, contact Megan Peach of Excel Physical Therapy at 406.556.0562 in our Bozeman office.

 

 

Pregnancy Exercise Recommendations Handout

By Megan Peach, DPT, OCS, CSCS
megan@excelptmt.com

Thank you to all who attended Megan Peach, DPT, CSCS’ presentation last night at the @Bozeman Library!  Per Megan’s recommendations, be sure to consult your health care provider before beginning or adjusting any exercise program.

Here is the link to Megan’s handout for the exercises discussed:

201306_exercise&pregnancy_handout

If you have any further questions, contact Megan at 406-556-0562.

"Pregnancy & Exercise: Rewards, Risks & Recommendations" Seminar June 5th, 2013 6:30pm

By Megan Peach, DPT, OCS, CSCS
megan@excelptmt.com

Community Education Seminar ~ free and open to the public

 

“Pregnancy & Exercise: Rewards, Risks & Recommendations” presented by Megan Peach, DPT, CSCS

  • Wednesday, June 5, 2013  6:30-7:30pm
  • Bozeman Library Large Community Room
  • Come dressed to move!

 

 

  • Discover the benefits and risks of aerobic and resistance exercise during pregnancy.
  • Learn how to exercise safely with specific exercise recommendations to do during pregnancy.
  • Ask Our PT: Q&A with Megan after the talk. 

Megan specializes in manual treatment of spinal dysfunction, as well as knee and shoulder pain. After receiving a Bachelor of Science in exercise science from Montana State University, Megan earned a doctorate in physical therapy from Duke University. Post-graduation, Megan became a Certified Strength and Conditioning Specialist and is currently a member of the National Strength & Conditioning Association. Shortly thereafter, Megan completed the Kaiser Permanente Residency program in advanced orthopedic manual physical therapy in San Francisco, California. Megan’s philosophy for physical therapy treatment embraces educating patients about the tools they need for enhancement of proper body movements during work and play to promote a pain and injury free active lifestyle.

Megan is an expectant mom herself and enjoys outdoor activities such as rafting, backpacking, photography, and especially loves hiking with her husband and great danes.

Join Excel PT on twitter #excelptmt and facebook for more details and community education series seminar updates.

Think You're Recovered From That Ankle Sprain?

By Megan Peach, DPT, OCS, CSCS
megan@excelptmt.com

Think you’ve recovered from that ankle sprain that happened a month ago? Think again! Even mild ankle sprains can increase your risk for recurrent ankle sprains and chronic pain if not properly rehabilitated

 

The majority of ankle sprains occur with ankle inversion, or when rolling the foot & ankle outward.

Figure 1: Ankle inversion

 

When the ankle is inverted too far in an uncontrolled manner, the ligaments that stabilize the lateral aspect of the ankle may be sprained or torn.

Figure 2: Lateral ankle with stabilizing ligaments marked in black.

 

Lateral ankle sprains, even mild ones, can result in decreased ankle stability, delayed reaction time, and impaired balance. If left untreated these factors do not spontaneously resolve and may increase your risk for future ankle sprains and possibly chronic ankle instability (CAI). CAI has been reported to occur in 40-70% of people who have suffered a lateral ankle sprain. A recent 2011 study in the Journal of Orthopaedic & Sports Physical Therapy found that six weeks of balance training improves dynamic balance & joint position sense, especially with ankle inversion motion. (Sefton et al, 2011)

 

Balance and stability may be impaired even after the pain from a mild sprain has resolved, and small impairments in balance can increase the risk for future ankle sprains. This is why balance training is essential after an ankle injury and can include as little as 10 minutes per day of exercises to improve your balance.

 

Balance training can be as simple as standing on one foot on solid ground or as difficult as jumping from side to side on one foot. Balance training can begin as early as one week after an ankle sprain, and should be continued with increasingly difficulty exercises 3-4 times per week for at least 6 weeks.  

 

Examples of balance exercises are listed below in order from least to most difficult:

  • Standing on a single leg
  • Tightrope walking
  • Standing on a single leg & tossing/catching a ball
  • Standing on a single leg while reaching towards the floor
  • Standing with both feet on balance board & rocking side to side
  • To increase the difficulty of a balance exercise, add an unstable surface such as a foam cushion or a Bosu ball

Disclaimer: This blog article is not intended for diagnostic purposes or treatment prescription; the purpose of this article is for general information only. If you have an ankle injury, see your primary care practitioner, physical therapist, or orthopedic specialist for diagnosis and treatment options.

–Megan Peach, DPT, CSCS  | megan at excelptmt.com

 

JM Sefton et al. Six Weeks of Balance Training Improves Sensorimotor Function in Individuals With Chronic Ankle Instability. JOSPT  2011;41(2):81-89

Ab Routines for Injury Prevention

By Megan Peach, DPT, OCS, CSCS
megan@excelptmt.com

Need a good reason to re-start that ab routine? How about injury prevention!

The “core” is a combination of active and passive components including the abdominal muscles, pelvic muscles, spinal column and pelvis.  “Core stability” essentially means the ability to control the position & motion of the trunk to allow for the transfer of force & energy from the spine to the extremities.

Recent studies are showing a relationship between core stability & lower extremity injuries and are finding that decreased core stability may actually increase the risk for lower extremity injury such as hip, knee and ankle injury. Good core stability will provide the lower extremities with a solid base to run, jump, kick, and play!

Here is a selection of exercises to strengthen your core stability to help reduce potential injuries in the lower extremity and for overall improved stability.

  • Supine Marches:  Lie on your back with your hips and knees bent to 90 degrees. Tighten your abdominals and slowly lower one leg at a time keeping the 90 degree bend in the knee and then return to the starting position. Alternate lowering each leg & do not let your lower back arch off the floor.

  • Perform 1 minute bouts to fatigue.

Supine 1Supine 2

  • Bridges: Lie on your back with knees bent & feet flat on floor. Tighten abdominals and gluts & lift buttocks off floor as if you are making a “bridge” with your body.

  • Perform 25-30 repetitions or to fatigue

Bridges 2Bridges 2

  • Prone planks: Maintain plank position by tightening abdominals & without letting low back sag. Hold 15-60 seconds, 2-3 repetitions

Prone Planks

  • Side planks: Maintain position without by tightening abdominals & without letting hips sag.  Hold 15-60 seconds, 2-3 repetitions each side

Side Planks

Click here to print the above program: Ab Routines for Injury Prevention Handout

Contact us with any questions about these exercises.  (Always consult a medical professional before beginning or changing an exercise program.)

 

Megan Peach, DPT, CSCS

megan at excelptmt dot com
Excel Physical Therapy Bozeman
406.556.0562

"Very thorough when it came to diagnosing the problem...David Coletta took the time necessary to figure it out." --Bozeman Patient

View more testimonials from Excel PT clients »