Matt Heyliger, DPT, physical therapist with Excel Physical Therapy of Bozeman and Manhattan, recently completed the North American Institute of Orthopedic Manual Therapy (NAIOMT) Level II course held in Seattle, WA with a focus on assessment and treatment of lower extremity conditions. The course emphasized assessment of the foot and ankle addressing correlations with foot and ankle biomechanics and overall lower extremity function. Many mobilization and manipulation treatment techniques were presented for the foot, ankle, and knee. Matt has now completed all Level I, II and III courses through NAIOMT, the equivalent of 231 hours of hands-on continuing education coursework in manual therapy.
Knee painOlder Posts »
Jackie Oliver, DPT, physical therapist with Excel Physical Therapy of Bozeman and Manhattan, recently completed the Kevin Wilk Shoulder and Knee Course in Seattle, Washington. This advanced-training course presented the most recent, relevant and state-of-the-art treatment options for the most challenging and unusual problems of the shoulder and knee joints. This evidence-based course also focused on the most comprehensive and effective information regarding shoulder and knee post-operative treatment as well as rehabilitation tactics for general knee and shoulder pain. Kevin Wilk is our country’s leading authority in sports and orthopedic injury rehabilitation.
Have you ever stood in front of a wall of running shoes wondering which shoe is right for you? Maybe the Hokas with the super cushioned sole that feel like you’re running on clouds? Or the Brooks trail runners since the trails have cleared up and you’ve been wanting to try out the North Cottonwood trail? Or maybe the Saucony minimalist shoes because you’ve recently read about the benefits of minimalist running? Or my personal favorite, the hot pink shoes with tie-dye laces?!
You may think that based on the available technology for running shoes and advancements in materials used to create modern running shoes that a plethora of running shoe research would be available. However, this is not necessarily the case.
Although the modern running shoe has been around for the past 40 years since the running boom in the 1970s, research specific to running shoes and injury is relatively new within the past few years. A wide variety of shoe functions exist in running shoes from a cushioned sole for shock absorption, motion control to decrease over pronation, a trail runner, or a minimalist shoe. While some runners may benefit from a specific type of shoes, recent studies on footwear for runners suggest that when shoes or orthotics are selected for comfort rather than function this results in a decreased frequency of running related injury.
So, unfortunately, you can’t base your choice on shoe color alone, but if the pink shoes with tie-dye laces have the best fit and are the most comfortable, they are also the most likely to keep you out of an injury!
Megan Peach, DPT, OCS, CSCS specializes in manual treatment of spinal dysfunction, as well as knee and shoulder pain and is a member of the Excel Physical Therapy running specialist PT team. 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.
Check out the latest issue of Outside Bozeman for Jason Lunden, DPT, SCS’ article, “Hip to Be Cool” to review the principles of running injury prevention to keep your running season injury-free.
Patellofemoral pain, or anterior knee pain, is the most common type of knee pain in Nordic skiing. Repetitive stress to the soft tissue around the patella (knee cap) occurs due to poor tracking of the patella in the femoral groove. This poor tracking can be the result of hip weakness causing poor control of movement of the femur (thigh bone), poor stabilization from the foot and ankle, and poor skiing technique.
Nearly all injuries in alpine skiing are classified as traumatic, or due to a fall. As mentioned earlier, under Strength & Injury Prevention, the majority of knee injuries in alpine skiing occur on the left knee. Therefore it is important to work on your ski technique to be able to turn equally well to your right and left. With the snowpack being shallower and conditions not yet epic, the early season is a great time to work on perfecting your turns. Aim to stay balanced on your skis with your hips centered and perfect your turns to both sides. A Professional Ski Instructor or coach can make all the difference, so take the time to perfect your technique by taking a lesson at one or our local ski resorts, or sign-up for coaching from a community ski team such as the Bridger Ski Foundation (BSF).
Developing and performing a proper pre-season/dry-land strengthening program can help to reduce your risk of injury and improve your performance. Alpine skiing is unique in that it places equal demands on both sides of the body, as one has to be able to turn equally well to the right and the left. Research has found that the left knee is most often injured in alpine skiing1. Therefore it is important to compare the strength of your right and left legs to get the most out of your workouts. (more…)
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. (more…)
Do you have patellofemoral knee pain? A recent study by Christopher Powers et al. in the Journal of Orthopaedic & Sports Physical Therapy suggests that knee angle during quadriceps strengthening exercises affects patellofemoral joint stress. Because excessive joint stress may contribute to patellofemoral pain, the author’s purpose was to determine which exercises were minimally stressful to the knee.
During the squat exercise, joint stress was the least in the standing position, and increased as a subject descended into the squat position, peaking at 90 degrees of knee flexion. In an open chain seated leg extension exercise the joint stress was variable depending on the type of weight used, however joint stress was generally greater when the leg was fully extended.
The authors suggest that a squat exercise from standing to 45 degrees knee flexion coupled with an open chain seated leg extension from 90 degrees to 45 degrees knee range of motion is the best combination to minimize patellofemoral joint stress and therefore strengthen the quads without increasing pain.
We can help you if you suffer from patellofemoral knee pain. Call us at 406-556-0562 (Bozeman) or 406-284-4262 (Manhattan).
Plantar Intrinsic Training
Over-pronation (the inward roll of the foot while walking or running) is a common contributing factor in the development of several lower extremity injuries including plantar fasciitis, Achilles tendinopathy, patellafemoral knee pain and other overuse conditions. Recent research addressing the contributing factors to the development of plantar foot pain (pain at the bottom of your foot) has emphasized the importance of training the muscles of the foot to keep the arch from collapsing inward. It has been proposed that the intrinsic plantar muscles of the foot play a similar role in arch preservation as the core muscles play in the stabilization of the trunk and spine. This concept provides a great foundation for direct treatment of conditions associated with over-pronation.
A recent study by Mulligan and Cook, published in the journal “Manual Therapy,” presented this concept and sought to test if the performance of a series of exercises (named “Short Foot Exercises”) directed at isolating the recruitment of the plantar foot muscles could decrease pronation after four weeks of training. They discovered a small, but significant difference in arch height and these differences were preserved after eight weeks without continued training. While these exercises are tedious and initially challenging, our patients here at Excel Physical Therapy are responding well to these exercises. If you have been dealing with plantar foot pain and are not responding to other therapies or orthotics, consider training the “core” of your feet with Short Foot Exercises.
Be sure to contact a licensed health professional before starting any exercise plan and for a thorough evaluation or diagnosis of your issue. We can help. Call us in Bozeman at 406.556.0562 or in Manhattan at 406.284.4262.
About Matt Heyliger, DPT:
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.
"Jason is always in a cheerful mood & goes out of his way for patient comfort. He is a true professional in his field. My progress is more than I expected." --Manhattan PatientView more testimonials from Excel PT clients »