Direct Access to Physical Therapy

Expanded Appointment Hours & Days in our Manhattan Location!

By Tiffany Coletta
tiffany@excelptmt.com

Excel Physical Therapy has expanded our treating hours in our Manhattan location! Our physical therapist team is treating patients Mondays through Thursdays. We see patients on Mondays, Tuesdays and Thursdays from 7:30am-6pm, and Wednesdays from 8:15am-5:15pm. Please call us at 406-284-4262 to schedule a physical therapy appointment that is convenient for you or to see how physical therapy can help you.

Visit us at excelptmt.com to learn more about our practice and for a clinic location map. We are located next to the Manhattan Athletic Club in Manhattan, Montana and have been proudly serving the Manhattan, Amsterdam, Belgrade and Three Forks communities since 2002.

Excel Physical Therapists of Bozeman & Manhattan are CareCredit Providers

By Tiffany Coletta
tiffany@excelptmt.com

CareCredit_Tag_CMYK

Excel Physical Therapy of Bozeman and Manhattan, Montana are CareCredit providers. CareCredit is a personal healthcare credit card which acts like a revolving line of credit for out-of-pocket healthcare expenses. Our office offers the option of no interest for 6 months. Our patients and their families can use their CareCredit account to pay for deductible, and or co-payments over a $200 minimum balance. 

Apply for a CareCredit account online at www.carecredit.com or via 800-677-0718. Patient Responsibility charges from our office are paid at the end of each visit until our office team can verify active CareCredit account status.

Please inquire with our front office team if you have additional questions at 406-556-0562 for Bozeman or 406-284-4262 for Manhattan or via info (at) excelptmt (dot com).  Thank you for choosing Excel Physical Therapy for your physical therapy needs. We truly appreciate our patients and hope you will consider us in the future and refer us to your friends and family.

Knee Repair? Study finds PT as good as surgery for torn cartilage, arthritis

By Tiffany Coletta
tiffany@excelptmt.com

Knee repair? Study finds physical therapy as good as surgery for torn cartilage, arthritis. 

  • Article by: MARLYNN MARCHIONE , Associated Press
  • Updated: March 19, 2013 – 11:52 AM
  • Published in the Minneapolis Star Tribune
  • Photo: Jennifer Simonson, Star Tribune

You might not want to rush into knee surgery. Physical therapy can be just as good for a common injury and at far less cost and risk, the most rigorous study to compare these treatments concludes.

Therapy didn’t always help and some people wound up having surgery for the problem, called a torn meniscus. But those who stuck with therapy had improved as much six months and one year later as those who were given arthroscopic surgery right away, researchers found.

“Both are very good choices. It would be quite reasonable to try physical therapy first because the chances are quite good that you’ll do quite well,” said one study leader, Dr. Jeffrey Katz, a joint specialist at Brigham and Women’s Hospital and Harvard Medical School.

He was to discuss the study Tuesday at an American Academy of Orthopaedic Surgeons conference in Chicago. Results were published online by the New England Journal of Medicine.

A meniscus is one of the crescent-shaped cartilage discs that cushion the knee. About one-third of people over 50 have a tear in one, and arthritis makes this more likely. Usually the tear doesn’t cause symptoms but it can be painful.

When that happens, it’s tough to tell if the pain is from the tear or the arthritis — or whether surgery is needed or will help. Nearly half a million knee surgeries for a torn meniscus are done each year in the U.S.

The new federally funded study compared surgery with a less drastic option. Researchers at seven major universities and orthopedic surgery centers around the U.S. assigned 351 people with arthritis and meniscus tears to get either surgery or physical therapy. The therapy was nine sessions on average plus exercises to do at home, which experts say is key to success.

After six months, both groups had similar rates of functional improvement. Pain scores also were similar.

Thirty percent of patients assigned to physical therapy wound up having surgery before the six months was up, often because they felt therapy wasn’t helping them. Yet they ended up the same as those who got surgery right away, as well as the rest of the physical therapy group who stuck with it and avoided having an operation.

“There are patients who would like to get better in a `fix me’ approach” and surgery may be best for them, said Elena Losina, another study leader from Brigham and Women’s Hospital.

However, an Australian preventive medicine expert contends that the study’s results should change practice. Therapy “is a reasonable first strategy, with surgery reserved for the minority who don’t have improvement,” Rachelle Buchbinder of Monash University in Melbourne wrote in a commentary in the medical journal.

As it is now, “millions of people are being exposed to potential risks associated with a treatment that may or may not offer specific benefit, and the costs are substantial,” she wrote.

Surgery costs about $5,000, compared with $1,000 to $2,000 for a typical course of physical therapy, Katz said.

One study participant — Bob O’Keefe, 68, of suburban Boston — was glad to avoid surgery for his meniscus injury three years ago.

“I felt better within two weeks” on physical therapy, he said. “My knee is virtually normal today” and he still does the recommended exercises several times a week.

Robert Dvorkin had both treatments for injuries on each knee several years apart. Dvorkin, 56, director of operations at the Coalition for the Homeless in New York City, had surgery followed by physical therapy for a tear in his right knee and said it was months before he felt no pain.

Then several years ago he hurt his left knee while exercising. “I had been doing some stretching and doing some push-ups and I just felt it go `pop.'” he recalls. “I was limping, it was extremely painful.”

An imaging test showed a less severe tear and a different surgeon recommended physical therapy. Dvorkin said it worked like a charm — he avoided surgery and recovered faster than from his first injury. The treatment involved two to three hour-long sessions a week, including strengthening exercises, balancing and massage. He said the sessions weren’t that painful and his knee felt better after each one.

“Within a month I was healed,” Dvorkin said. “I was completely back to normal.”

___

AP Medical Writer Lindsey Tanner in Chicago contributed to this report.

___

Marilynn Marchione can be followed on Twitter at http://twitter.com/MMarchioneAP

Lindsey Tanner can be followed on Twitter at http://www.twitter.com/LindseyTanner

Be Part of a Headache Research Study

By David Coletta, MPT, CMPT
david@excelptmt.com

Excel Physical Therapy Participates in a Research Study on Cervicogenic Headaches

 

Seeking Research Study Participants

Headaches can cause lost time from work, visits to multiple physicians, and a general loss in quality of life.  The major categories include migraine headaches, tension headaches, TMD headaches, and cervicogenic headaches.  While cervicogenic headaches are not the most common type of headache, the prevalence in the general population is estimated at 15%.

Cervicogenic headaches are defined as one sided, or one side dominant, head pain, which is caused by a neck problem.  Other symptoms include stiffness in the neck, decreased range of motion in the neck, increased headaches with neck movements or poor cervical postures, and a possible history of trauma.  Although physical therapy can be effective in treating tension headaches and TMD related headaches, cervicogenic headaches have shown, in multiple studies, excellent response to manual therapy.  Mechanical joint and muscle restrictions in the neck lead to a referral of pain into the head (cervicogenic headache).  Manual therapy based physical therapy utilizes hands-on techniques to restore muscle and joint mobility, eliminating the head pain. 

Interestingly, research indicates that manual therapy success in treating cervicogenic headaches does not depend on chronicity. Cervicogenic headache patients can benefit from manual therapy treatments whether the symptoms have been present for 20 days or 20 years!  As a manual physical therapist for 15 years, my success rate with treating cervicogenic headaches has been very high. Our research from this study hopes to clinically show which manual therapy techniques are the most effective for treating cervicogenic headaches.

Excel Physical Therapy is enrolled as a clinical site in a national research study to determine the best manual therapy techniques to treat cervicogenic headaches.  There are several other clinical sites throughout the United States also collecting data on real patients being treated in a physical therapy environment.  Mobilization or manipulation of the neck and upper back are the two manual therapy variables in this study.  Mobilization is a joint “popping” technique and mobilization is a joint “stretching” technique. 

The Treating PT at our clinical site is skilled and trained in performing both spinal mobilization and manipulation.  One treatment group will receive only manipulation and the other treatment group will receive only mobilization and exercise.  We anticipate that both groups will benefit from the manual therapy treatments, but the magnitude of improvement is part of our research question.  Both groups will have 6 physical therapy visits over 2 to 4 weeks.

We are looking for patients to be part of this study – To be included:

  • patients must have one side dominant head pain, pain in the neck or the base of the skull that is felt to project into the head, and at least one headache per week for at least 3 months. 

  • Patients cannot be included in the study if they have a history of stroke, high blood pressure, high cholesterol, diabetes, heart disease, peripheral vascular disease, smoking, or whiplash injury to the neck in the last 6 weeks. 

  • Patients are not being offered free treatments in this study.  As with all of our patients, cost for physical therapy services will follow our normal fee schedule and we are happy to bill your insurance or provide you with a payment plan.  In most cases, a doctor’s prescription is not required to receive physical therapy services in Montana.  Excel Physical Therapy is a preferred provider for many insurance companies as well.

 

Please contact me if you meet the criteria for this study or if you have any questions.

David Coletta, MPT, CMPT -Treating Physical Therapist

david at excelptmt.com (insert the @ sign in your email message)

406-556-0562

What Does Direct Access to Physical Therapy Mean?

By Tiffany Coletta
tiffany@excelptmt.com

Unlike some states where patients require a referral from a physician to be treated by a physical therapist, here in Montana you are entitled to “direct access” which means you are able visit your physical therapist directly whenever you are in pain, no prescription required.  The vast majority of major insurance companies will cover physical therapy the same way, whether or not you have seen a doctor first.  The rest of the country is beginning to follow our lead and the transition to direct access is occurring state by state as both insurance companies and health care providers realize the improved quality of care and reduced costs afforded by its implementation.   

The greatest direct access benefit for patients is the ability to get better faster.  Numerous back pain research articles consistently point to one variable as being the most important in the overall success of a patient’s physical therapy treatment:  How soon the physical therapist was able to begin initiating treatment after the injury.  If the therapist was able to start working with the patient within two weeks of the injury, results were significantly better than those patients who allowed more time to elapse before treatment.   

In an increasingly complex health care system, it is great to know that, here in Montana since 1987, we as physical therapists are able to maximize treatment results for our patients by addressing the problem immediately.

However, we as providers are still at the mercy of an insurance companies own rules despite our Montana state law. Therefore, please always check with your insurance company and their specific physical therapy outpatient benefit rules to ensure maximum reimbursement and coverage for your treatment. Our Patient Service Coordinators are happy to help you through this insurance coordination. Just call either of our offices in Bozeman or Manhattan.

"We will use Jason whenever needed. Happy to have created the relationship." --B.C & C.C., Bozeman Patients

View more testimonials from Excel PT clients »