Summertime: the birds are chirping, the flowers are blooming, and the mountains are calling. If you answer that call with vigorous running or biking, at some point you are probably going to fall or crash. Falls often result in injuries and, depending on the severity, can lead to time away from your chosen activity.
Before we talk about minimizing the severity of a fall, let’s first talk about reducing your risk of falling in the first place. There are two areas to focus on before hitting the trails at speed…
Q: I fell yesterday walking and I have fallen a lot. All I can think of is, I am not picking up my feet enough? When I hit a crack or something I hit my toe and fall forward.
A: Sometimes that can be a strength thing, maybe your body is not strong enough, not that you can’t do it, but as you fatigue when you’re walking, you’re not lifting your feet as high because you are getting tired. So, your endurance might not be there in the lower extremity. It can be a multitude of factors…it could be your proprioception in the bottom of your feet aren’t picking up the cracks. A physical therapy evaluation can assess exactly what is causing your balance issues. As we get older, we tend to have balance issues that happen a little easier. We definitely don’t want you falling, especially outside on the hard concrete, that’s not a great place to be falling. Definitely worth a mention to your doctor or physical therapist about what you are experiencing so a plan can be put into place to help address this issue for you.
Q: I am someone who is dealing with peripheral neuropathy in my legs and feet, what do I do? Also, I am not able to lift my feet high enough when walking due to peripheral neuropathy.
A: So what you will want to do is uptrain like we talked about in that pie chart. We talked about a third, a third, and a third for vision, vestibular and peripheral neuropathy. The pie chart section that focuses on peripheral neuropathy is closing because you don’t have the sensation in your feet anymore. So you have to uptrain those other systems in order to compensate for the proprioception loss. Yes, it’s absolutely trainable. Not being able to lift your feet high enough is a strength thing, with peripheral neuropathy, you’re not going to change the peripheral neuropathy, you’re going to uptrain those other systems. It’s like a muscle making those other systems stronger, so you aren’t worried about the peripheral neuropathy impact as much.
Q: Is there somewhere we can access the charts that you were talking about?
A: The whole presentation will be loaded onto the Facebook page and the Excel website with the slides. (coming soon)
Q: What would you recommend as a call assist company for around your neck so if you fall you can get assistance?
A: With a little research online or by talking with family or friends, you can find one that will work with you. Recommendation given about Apple watch that asks if you have fallen and sends GPS tracking on where you are at if you don’t answer.
Q: Is there a booklet or something we can get with a detail view of different exercises we can build on for helping with resistance to falling?
A: A physical therapist can help determine a customized exercise program to help you with this. Also, tai chi, like yoga, is a great program to help with significant help on falling, some research showing up to 3 times a week has helped. Talk to your physical therapist, because we can have different deficiencies because you may be deficient in your quads and hamstrings somebody else may be deficient in their glutes. You may struggle with lifting your feet up and somebody else will struggle when they start doing head turns so getting a really specific exercise program is probably the best advice, so you’re not wasting your time so you’re not working on exercises you don’t need to work on.
Q: Does Medicare cover balance training?
A: Yes, Medicare does cover balance training during a physical therapy appointment.
Q: Do you have suggestions on footwear?
A: Making sure you are in a footwear that you are comfortable walking in. Something that isn’t bulky or has a high heel on it or has a big thick sole on it where you can get it caught on cracks in sidewalks. Flip flops, sandals in the Summer time are going to be hard to justify because they can slip on feet and effect balance. Specific footwear would be something to talk to your physical therapist to get headed in the right direction.
Q: Height of chair seat for a sit to stand desk?
A: There is a standard height, generally the measurement is dependent on height of the person using the desk. A physical therapist can help you determine the ideal measurements best suited for your positioning needs.
Q: Balance with a new hearing aid?
A: Vestibular system is a big part of our balance system that contributes to balance and having a new hearing aid can throw of your balance because things are different for you.
Jackie Oliver, DPT, OCS completed her Doctorate in Physical Therapy at the University of Utah in Salt Lake City, Utah, one of the top Physical Therapy schools in the nation. She was fortunate enough to complete her clinical rotations and begin her physical therapy career within the University of Utah system, which is consistently ranked near the top in healthcare. Exposed to a wide variety of orthopedic conditions, Jackie is confident when assessing and treating a broad range of orthopedic impairments. Jackie is a certified dry needling provider with advanced training from Evidence in Motion and KinetaCore. Jackie achieved the Orthopedic Clinical Specialist advanced certification after extensive advanced training coursework and a stringent examination process from the American Physical Therapy Association.
Jackie has an intense passion for helping and educating others as well as preventative medicine. Because of her college sports background, Jackie loves working with athletes and has experience with biomechanical training and injury prevention in sports. She is also trained as a Diabetes Lifestyle Coach and has worked for the University of Utah and CDC helping individuals decrease their risk of developing diabetes.
Prior to completing her Doctorate in Physical Therapy, Jackie played basketball for Carroll College in Helena, Montana, while also obtaining a Bachelor of Arts degree in Health Science. Jackie was Academic All-American her last two years at Carroll.
A deep vein thrombosis (DVT) occurs when a blood clot or thrombus forms in one of your deep veins due to slow moving blood. Most often a DVT occurs in the calf or lower leg, however a DVT can also form in other regions of the body such as the arm. Learning what puts you at risk for developing a DVT, as well as being able to identify the signs and symptoms associated with this medical condition is important for prevention of more serious complications like a pulmonary embolism (blocking blood flow to the lungs).
The signs and symptoms of a DVT can include swelling in the affected leg, usually in the calf. This will normally feel sore and tender to touch. You may also see redness and warmth associated with the swelling. The hallmark sign of a DVT is that the pain does not increase or decrease with a change in position. DVTs can mimic a musculoskeletal injury like a calf strain without other symptoms like swelling and redness. The thing to remember is that a calf strain would have a mechanism of injury or a specific onset, whereas a DVT would have a history of prolonged sitting or recent surgery.
Risk factors that increase the likelihood of developing a DVT include: a recent surgery, prolonged bed rest, pregnancy, smoking, age or sitting for long periods of time like when you are driving or flying.
If you find yourself in one of these categories there are a few measures you can take for prevention:
1.) Avoid sitting still for prolonged periods. If you do have to be sitting or immobile for prolonged periods such as long plane flights or being laid up in bed recovering from a surgery or sickness, try pumping your feet up and down to get your muscles working and the blood flowing in your legs.
2.) Wearing compression stockings during periods of immobility can help decrease the risk of developing a DVT. Talk to your doctor or physical therapist about getting compression stockings for travel or after surgery.
3.) Regular exercise can also lower your risk of blood clots. A new study published by the Journal of Thrombosis and Haemostasis states that participation in sports, regardless of intensity, can lower your risk of developing blood clots by up to 39%. Regular exercise also decreases your BMI, which can also lower your risk.
If you think you have symptoms related to a DVT it is important to get it checked out at an Urgent Care or Emergency Department as soon as possible. Your doctor will be able to detect a DVT using compression ultrasonography and will treat accordingly. DVTs can be a serious health problem but knowing the signs and symptoms can help prevent complications. Discovered early, complications from DVTs are preventable and easily treatable.
Jackie Oliver, DPT has an intense passion for helping and educating others as well as preventative medicine. Because of her college sports background, she loves working with athletes, biomechanical training and sport injury prevention. She is also trained as a Diabetes Lifestyle Coach and has worked for the University of Utah and CDC helping individuals decrease their risk of developing diabetes. Jackie is a certified dry needling provider with advanced training from Evidence in Motion and KinetaCore. Jackie also leads our Work Site Solutions programs.
How a physical therapist uses specialized techniques to help alleviate low back pain.
Learn proven exercises to help low back pain symptoms.
Q&A with Jackie after the talk. Please bring your questions.
Back pain is the most common complaint U.S. healthcare professionals receive daily. Come hear Jackie Oliver, DPT of Excel Physical Therapy discuss back pain and how you can find the pain relief you seek.
Jackie Oliver, DPT completed her Doctorate in Physical Therapy at the University of Utah in Salt Lake City, Utah, one of the top Physical Therapy schools in the nation. Jackie is a certified dry needling provider with advanced training from Evidence in Motion and KinetaCore.Jackie has an intense passion for helping and educating others as well as preventative medicine. Because of her college sports background, Jackie loves working with athletes and has experience with biomechanical training and injury prevention in sports. She is also trained as a Diabetes Lifestyle Coach and has worked for the University of Utah and CDC helping individuals decrease their risk of developing diabetes.Prior to completing her Doctorate in Physical Therapy, Jackie played basketball for Carroll College in Helena, Montana, while also obtaining a Bachelor of Arts degree in Health Science. Jackie was Academic All-American her last two years at Carroll.
According to the APTA website, one-third of people over the age of 65 and up to half of people over the age of 80 will end up falling this year. Falls can diminish your ability to lead an active and independent lifestyle. Decreased balance and increased risk of falling are two things that inevitably come with aging. Fortunately, there is something you can do about it.
Balance has contributions from three sources; the inner ear, the feeling on the bottom of the feet, and your vision. If anyone of these is affected it can really decrease your balance. For example, if you suffer from macular degeneration that affects your vision or diabetic neuropathy that affects your ability to feel the bottom of your feet, then you may be at greater risk of falling. Other contributing factors include age, lower extremity weakness, using a cane or other walking device, medical conditions like stroke or Parkinson’s disease or a history of previous falls. If you have any of these risk factors and are concerned about falling, then physical therapy can help.
Physical therapists are highly trained professionals that can conduct balance assessments to determine if you are at an increased fall risk. If the screening shows that you are at risk, we can design a program tailored to your specific needs to help decrease your risk of falling. Strength, gait, range of motion and balance are all things that may be included in your plan of care to improve balance.
Staying active is one of the best ways to reduce your risk of falling. Yoga, gardening, Tai Chi or a regular walking program are all things that have been shown to increase a person’s confidence levels, improve body awareness and improve balance. Falling or fear of falling should not simply be accepted as a normal aspect of aging. A lot can be done to improve balance and keep you functioning at your highest possible level and physical therapy can help you get there.
Direct Access. It sounds like an exclusive VIP backstage pass but, in reality, it’s an all access pass for individuals to see their physical therapist without a doctor’s referral. That’s right, you don’t have to spend time and money to go see a doctor before seeking physical therapy treatment.
A study done by GALLUP, asked individuals which profession was the safest and most effective for treating neck pain. Overwhelmingly people answered physical therapy. Though surprisingly when asked what profession they sought treatment from first, only 6% said physical therapy. Most went to their medical doctor first.
A lot of people are not aware that physical therapy is a direct access profession. Direct access benefits you in many ways. It streamlines your care, by eliminating the time between a physician’s appointment and getting in to see your physical therapist. By seeing your physical therapist first, you can start to improve your function, decrease pain and restore quality of life without delay. Furthermore, you could save hundreds of dollars on care. Medical doctors may do x-rays or prescribe medications that can end up costing a lot of money but don’t really solve your problems. Physical therapy is a great alternative to dangerous opioids and is often more effective than opioids, and in some cases surgery. If you think that your injury or pain is musculoskeletal in nature, a physical therapist should be your first stop. This will promote optimal outcomes and recovery.
Not sure if we can help? Physical therapists are highly-trained professionals that are well equipped to be able to recognize if a problem isn’t musculoskeletal in nature and, if necessary, able to refer you on to the proper health care professional to address your issue. Physical therapists are not meant to take the place the of physicians, in fact, we work very closely with them to optimize your care. Keep physical therapy in mind the next time you have an ache or a pain that just won’t go away. We can help get you back to doing what you love.
Call us today to schedule a thorough physical therapy evaluation in our Bozeman or Manhattan office.
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.
It’s summer time and all you want to do is to be outside enjoying the weather and many outdoor activities that Bozeman has to offer. The only problem is, you have this nagging low back pain holding you back. You keep thinking, should I stay home and rest it or do you push forward and continue participating in the activities that you love? Will you hurt your back more if you charge full steam ahead?
Statistics show that up to 80% of people will experience low back pain at some point in their lives. It is considered the leading cause of activity, limitation and work absence throughout much of the world. The good news is that most of the time, low back pain has a favorable diagnosis. The question remains, what do you do in the meantime?
Research shows that even though it might feel like you are doing your back a favor by taking a few rest days. In reality, you are doing yourself a disservice. It has been demonstrated that best rest after an acute onset of low back pain can lead to secondary complications such as depression, blood clots and decreased muscle tone.
Studies show that moving is the best medicine for your low back. Early resumption of normal or vocational activities will help you get back on your feet sooner. Promoting movement, such as stretching, while avoiding aggravating activities will help your back feel better. By incorporating low intensity, submaximal fitness and endurance type activities into your daily routine, you will help keep your back strong and decrease your chance of suffering from reoccurring low back pain. Specifically, exercises that target your core, low back and legs will help support your spine.
The thing to remember is that there are many different causes of low back pain and many ways to treat it. If movement and exercise doesn’t decrease your low back pain and it continues to persist, a visit to your local physical therapist may be beneficial to help get you on the fast track to feeling better.
Jackie Oliver, DPTcompleted her Doctorate in Physical Therapy at the University of Utah in Salt Lake City, Utah. Jackie is a certified dry needling provider with advanced training from Evidence in Motion and KinetaCore. Jackie has an intense passion for helping and educating others as well as preventative medicine. Because of her college sports background, Jackie loves working with athletes and has experience with biomechanical training and injury prevention in sports. Prior to completing her Doctorate in Physical Therapy, Jackie played basketball for Carroll College in Helena, Montana, while also obtaining a Bachelor of Arts degree in Health Science. Jackie was Academic All-American her last two years at Carroll. Jackie enjoys outdoor activities such as downhill skiing, trail running, disc golf and especially enjoys hiking with her husband and two dogs.
A big draw to the city of Bozeman, Montana is the proximity to recreational activities and easy access to outdoors. In this community, we are above average when it comes to being active but have we really decreased our health risks? We exercise on a regular basis so we don’t have to worry about the slogan “sitting is the new smoking”, right? Wrong. A growing body of evidence has demonstrated a decreased life expectancy for those individuals who sit for most of the day, even if they exercise on a regular basis. It is entirely possible to meet the current physical activity guidelines outlined by the World Health Organization, while still being incredibly sedentary. (more…)
"I adore everyone at Excel Physical Therapy. Over a 9 month period, Megan was not only my excellent physical therapist but she also became my friend and confidant. There are no words to express how much she helped me not only physically but mentally and emotionally to learn to cope with what proved to be a chronic, degenerative condition. Also, Nicole taught me more about my insurance coverage than the insurance company could have! Good luck to all of you and Thank You!" --Bozeman patient
Solid Stance - The fine art of falling by Jackie Oliver, DPT, OCS as seen in Outside Bozeman
