I have recently been thinking quite a bit about the importance of joint mobility, not strictly for function, but for joint health. In manual therapy, assessment of a given joint in the body always consists of consideration of joint mobility. Is there enough mobility? If not, why not? Does the joint itself have a motion restriction? Or is there perhaps some tissue outside the joint, like a tight muscle, that is limiting mobility? While it makes sense that a certain degree of motion is important for functional tasks, like bending your knee a certain amount to ascend stairs, mobility is also critical for joint health.

Joint pain is often accompanied by some loss of joint mobility. While it may be possible to get by with a small loss of motion this may be taking its toll on your joint. Taking a joint though it full available motion is critical to providing nutrition to a joint. Nutrients and metabolic waste products are housed in a joint’s synovial fluid and are moved in and out of a joint through motion. Each joint has a position, either fully bent or fully straight, that provides the most narrowing of the joint space. This position in physical therapy is called the close-packed position which allows the joint to excrete waste products. This in turn provides room to draw nutrients into the joint through the joint capsule. When one loses the ability to close-pack a joint it can lead to a slow degenerative process resulting in conditions like osteoarthritis and pain.

This principal applies to the smallest joints at the tips of the fingers, to the joints in the spine, as well as to larger joints like the shoulder and knee. If you have a joint that seems to be getting stiff consider having this assessed by an orthopedic professional. Preserve the motion of your joints and you will be taking an important step to promoting good joint nutrition and health.

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About Matt Heyliger, DPT: Matt completed his Doctorate in Physical Therapy at Eastern Washington University in Cheney, Washington. During his clinical experience with the Sports Medicine and Extremities team at The Orthopedic Specialty Hospital in Salt Lake City, Matt was exposed to a wide variety of surgical and non-surgical conditions and developed a solid foundation for the assessment and treatment of orthopedic conditions related to the extremities. Prior to completing his Doctorate of Physical Therapy degree, Matt obtained his Bachelor’s Degree in in philosophy at the University of California, Santa Barbara.

 
Matt has developed a specific interest focus in biomechanics and how impairments at one level or joint affect other body structures. More specifically, he has a particular interest in the relationship of cervical/thoracic spine mechanics and upper extremity conditions. Matt is an avid rock climber, telemark/backcountry skier and mountain biker. Matt regularly practices yoga and enjoys frequent adventures in the mountains with his wife and their Alaskan Malamute.
 
Matt treats patients out of the Excel Physical Therapy offices in Bozeman and Manhattan, Montana offices. You may schedule an appointment with him at 406.556.0562 (Bozeman) or 406.284.4262 (Manhattan).

Excel Physical Therapy‘s Physical Therapy team will be on the field during the Blitzz FC Yellowstone Kick-Off Classic 2015 soccer tournament to help with on field medical needs and injury screens. Look for our flag and booth. We’re here to help!

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Join us for Excel Physical Therapy’s Fall 2013 Community Education Series Seminar

“Why Do Kids Get Injured? A Youth Sports Injury Seminar for Parents, Coaches and Athletes Ages 18 & Under”

Thursday, September 12, 2013

6:30-7:30pm

Bozeman Public Library Community Room

free and open to the public

Jason Lunden, DPT, Specialist in Sports Physical Therapy, presents a free talk that will focus on the following:

 

For more info: info “at” excelptmt.com or excelptmt.com/seminars

Jason Lunden, DPT, SCS specializes in the rehabilitation and prevention of sports-related injuries, with a particular interest in the biomechanics of sporting activities – running, cycling, skiing, snowboarding and overhead athletics. He has published on the topic of shoulder biomechanics and the rehabilitation of knee injuries and has a strong commitment to educating others. Jason serves as a physical therapist for the US Snowboarding and US Freeskiing teams and is a frequent, well-received local and national presenter on the topics of sports rehabilitation and injury prevention. He is a recent recipient of the New Horizon Award from the American Physical Therapy Association and he as received advanced training in dry needling techniques for the extremities.

So we’re bringing David Coletta, MPT, CMPT’s 4/27/2011 seminar announcement to the local radio airwaves…Click this link to listen: KZMY Announcement -Excel Physical Therapy

On April 27th, 2011, 6:30-7:30pm, Join Certified Manual Physical Therapist, David Coletta, MPT, CMPT at the Bozeman Public Library, Community Room for a discussion of “TMJ Dysfunction/Jaw Pain: Help Yourself with Specialized Physical Therapy”.

David Coletta, MPT, CMPT

Learn the source of your facial pain and headaches, as related to jaw muscle imbalance and joint dysfunction of the jaw and the neck.  Learn how to treat yourself with some simple exercises and techniques and how a specialized physical therapist can specifically help you.  Q&A with David to follow so you can ask specific questions regarding any jaw, facial pain or headaches.

 

David Coletta, MPT, CMPT is a certified manual physical therapist through NAIOMT and for over 14 years has specialized in treating facial pain, TMJ dysfunction, headaches, and neck pain.  Coletta is the owner of Excel Physical Therapy in Bozeman and Manhattan, Montana which is celebrating their 10th year of service to the Gallatin Valley this year.

 

To sign up for future seminar announcements, join our e-list @ www.excelptmt.com.

TMJ Defined

Temporomandibular Joint (TMJ) Dysfunction is a disorder of the joint where the jawbone meets the skull or the muscles surrounding that region. People suffering from TMJ Dysfunction complain of popping or locking in the jaw, pain in the face with eating or opening the mouth, and headaches. TMJ Dysfunction can be further classified into joint dysfunction, myalgia, or a combination of dysfunction and myalgia. Myalgia is simply defined as intra-muscular pain. Pure joint dysfunction of the TMJ involves popping in the jaw, pain coming from joint structures (bone, cartilage, disc, ligaments, joint capsule), and a predictable and measureable loss in mouth opening or closing range of motion. Myalgia in the TMJ region relates to inflammation and dysfunction in the muscles surrounding the TMJ. These muscles can cause local facial pain, neck pain, headaches, and changes in how the jaw is actively moved. Combined joint dysfunction/myalgia of the TMJ is the most common presentation and can include all of the elements in the individual disorders previously described.

Underlying Causes

It is important to explain some the underlying reasons for TMJ dysfunction. The most obvious cause is a serious blow to the face or jaw, disturbing the normal biomechanics of the joint.  However, more common causes include chronically poor posture, stress-induced grinding of the teeth or clinching the jaw, malocclusion of the teeth (high or low tooth), and neck pain or trauma to the spine.  My experience has been that over 90% of patients that I treat, with the diagnosis of joint dysfunction or myalgia of the TMJ, present with dysfunctions of the neck.  These patients require a careful evaluation of the neck and treatment that includes joint mobilization or manipulation, soft tissue massage, and exercise to improve posture and restore pain-free jaw active range of motion.

Treatment

As with any orthopedic problem, the most important step in treating TMJ Dysfunction is to obtain the proper diagnosis by a specialist. Some physical therapists, dentists, and medical doctors are specialty trained in TMJ Dysfunction. Myalgia is the easiest presentation to resolve and treatment can involve simple self-massage exercises, range of motion exercises, nonprescription anti-inflammatory medication, and ice/heat to the face. Treating joint dysfunction of the TMJ involves exercises to re-educate joint motion and fabrication of an oral appliance (acrylic splint) to fit over the teeth, altering joint motions and forces. I would suggest that only specialist dentist fabricate an oral appliance. These devices are expensive and often have to be remade when a dentist who does not understand the intricacies of TMJ fabricates them. Combined joint dysfunction/myalgia requires the combination of treatment approaches.

"Please tell David...Dude, my back feels awesome today!" --Bozeman Patient

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