Understanding Dizziness & Vertigo: How Vestibular Physical Therapy Can Help
presented by Bobby Bemis, DPT, COMT, Dip. MT, FAAOMPT
Join us to learn about how you can stop your (or your loved one’s) dizziness and vertigo symptoms. Excel Physical Therapy’s Bobby Bemis is a Cervical Spine Physical Therapist Specialist and Emory University Certified Vestibular Rehabilitation Therapist. He will host an informative talk about how to treat vertigo, dizziness and other vestibular issues with the latest research-based treatments. Learn how specialized training and treatment approaches, along with state-of-the-art equipment can help you.
Demonstration of how infrared goggles are used for examination and treatment.
Bring your questions! Question and answer period with Bobby after the talk.
Click Here to learn why Bobby’s chose to become a Vestibular Specialist at Excel Physical Therapy
Bobby Bemis, DPT, COMT, DIP.MT, FAAOMPT is a fellowship-trained physical therapist at Excel Physical Therapy. Bobby specializes in orthopedic manual physical therapy of the cervical, thoracic and lumbar spine. Although the spine is his specialty, Bobby has a high level of training in all regions of the body. After receiving his undergraduate degree, Bobby earned a Doctorate in Physical Therapy, became a Certified Orthopedic Manual Therapist (COMT), Diplomat of Manual Therapy (Dip. MT), as well as becoming certified in trigger point dry needling. Bobby then went on to become Fellowship trained and was then designated as a “Fellow” with the American Academy of Manual Physical Therapy (AAOMPT) after passing a rigorous oral and practical exam. Only a very small percentage of physical therapists achieve this elite status. The “Fellow” is a physical therapist who has demonstrated advanced clinical, analytical, and hands-on skills in the treatment of musculoskeletal orthopedic disorders and is internationally recognized for their competence and expertise in the practice of manual physical therapy. Bobby achieved an Emory University Certified Vestibular Specialist designation due to advanced training and examination from the Emory University Vestibular Rehabilitation Competency-Based Course.
Your health and well-being are of the utmost importance to us at all times. Excel Physical Therapy and Massage is carefully monitoring local and national COVID-19 developments, which have moved us to implement policy in an effort to do our part for our clients, staff and community.
Here are our two COVID-19 policy requests:
If you are sick for any reason, with a fever, cough or are sneezing, then we ask you to not return for clinic appointments until your symptoms fully resolve.
If you travel to high-risk regions per the CDC, inside the US with specified community transmission (after clicking on the link, scroll down and then expand the plus sign next to States) or outside of the US that have a Level 3 Travel Health Notice (widespread, ongoing transmission), we are asking you to postpone attending clinic appointments until 14 days after your return date to the Gallatin Valley. This requested 14-day waiting period exists for symptom-free patients and is based on the current average of 5.1 days for the incubation period for symptoms to appear. Possible COVID-19 symptoms include fever, coughing, shortness of breath, or any combination of these complaints. If either of these requests create a hardship for you, please call us so your physical therapy provider can create a solution for you.
Excel Physical Therapy and Massage already has an existing best practice of frequent hand and wrist hygiene before and after each patient encounter, sanitizing and disinfection of equipment, all common areas, and hard surfaces several times per day throughout both clinic locations. We are further increasing our vigilance in these efforts for all staff members and following CDC guidelines.
Here are the CDC’s recommended preventative protocols for additional precaution and prevention:
For the vast majority of people, COVID-19 results in a mild illness. However, there are certain populations with underlying health issues that can experience a more impactful illness. Because we have some patients who are more vulnerable, the above policies being implemented are for their safety.
We are here for you! Our Bozeman and Manhattan teams are happy to help you with all of your physical therapy and massage therapy needs. As always, your physical therapist is available through email or phone and we encourage you to communicate with them regarding your care.
Appointment planning. If you need to postpone future clinic appointments because you are sick for any reason or because of our high-risk travel quarantine request policy, then please call us at your very earliest opportunity as we have clients on our waiting list for appointments. More than 24 hours’ notice for canceling is preferable, but less than 24 hours will be accepted during this time.
Thank you for your patience with our precautionary efforts. We are in this together. Take good care, All of us at Excel
Excel Physical Therapy team is proud to welcome Nikki Kimball, MSPT to the team. One-on-one specialized physical therapy with the ultra running expert dedicated to helping people.
Nikki Kimball is a Physical Therapist, Runner’s World Health Advisory Board Member, 2008-2016, Professional Runner, and a RRCA Certified Running Coach.
Nikki specializes in the treatment in running injuries and has been treating runners since 1999. She graduated with her MS degree in physical therapy from Arcadia University in 1998 and won the school’s Health Sciences’ Alumni Achievement Award in 2017 for her work integrating professional running, physical therapy and advocacy for people with mental illness. She is certified in ASTYM soft tissue mobilization and in dry needling. She has been an expedition physical therapist for running events in Africa, China and India.
Prior to her professional running career, Nikki was a cross country skier and biathlete. She raced NCAA Division I for Williams College where she won the Alumnae Ski Award two times. In 2018 she won the Distinguished Alumni Award at Holderness School for her using her athletic achievements as a platform to provide service “for the betterment of humankind” in areas of advocacy for health care and gender equity. She is a three-time North American Ultrarunner of the Year and three-time United States Track and Field Association Ultrarunner of the Year. She has won 11 National Championship titles and has been named to 14 US National Teams across three athletic disciplines.
Nikki presents on exercise prescription and physical therapy at psychiatric and adventure sports medicine conferences on the west coast and Rocky Mountain states. She has spoken professionally about running and injury prevention on three continents and at the US Embassy in Beijing, China. She has published articles in major print sports magazines in Asia, Europe and the US, including 13 pieces on injury prevention for Runner’s World. She has appeared in various films including a starring role in the regional Emmy winning feature, Finding Traction
Her treatment philosophy is to combine her physical therapy training and continuing education with decades of practical experience as a high-level competitor and coach to achieve the best possible results, particularly in the realm of complex running injury. When not working or adventuring, Nikki enjoys archery, wire sculpting, and cooking at home with her friends and pets.
Summer is finally here and with it comes all of the fun outdoor activities we love doing. But what if your best laid intentions to get outside are derailed with sore feet? Did you know that physical therapy is an effective treatment option for foot pain?
Foot pain is generally multi-faceted. There is rarely one simple cause for the pain, nor is there often a quick fix. However, there are often some common themes that put you at a higher risk for pain. One common cause is reduced mobility at one of the multiple joints of the foot/ankle complex. Decreased mobility at one joint can lead to excessive mobility at other joints throughout the foot. It is common for hyper- or hypomobility to be a pain generator for the foot. Another common cause is decreased strength or motor control of important stabilizing muscles throughout the lower extremity. This can change the way your foot absorbs shock or pushes off, thus putting excess stress on parts of the foot that weren’t designed to take that excess stress. Altered biomechanics of the lower extremity throughout the gait cycle are another common cause of pain.
Physical therapists are highly trained experts in recognizing faulty biomechanics throughout the body. By recognizing where the faulty mechanics lie, you can then effectively treat the root cause of your pain rather than simply the symptoms. This is helpful in not only reducing your pain, but giving you the tools to treat it in the future should your pain creep back into your life. At Excel Physical Therapy, we also specialize in affordable, semi-custom orthotics that are specially designed to your unique foot structure. Orthotics can help place your foot in it’s optimal biomechanical position to reduce stress and optimize function.
If you have foot pain, the physical therapists at Excel Physical Therapy can help! We provide a specialized approach to physical therapy that provides the most effective manual, orthopedic, and sports therapy treatments, allowing our patients to return to their highest level of function as quickly as possible. We have proudly been serving the Gallatin Valley in both Bozeman and Manhattan since 2001. Call us today to schedule an appointment!
Megan Kemp, DPT, ATC, CSCS, a Gallatin Valley native and graduate of Manhattan Christian High School, received her Doctorate in Physical Therapy from the University of Montana. She graduated with her Bachelor’s degree in Athletic Training from Point Loma Nazarene University in San Diego, California and is a board-certified athletic trainer through the National Athletic Trainer’s Association. Megan also completed training from the National Strength and Conditioning Association and is a Certified Strength and Conditioning Specialist. She has served as an adjunct faculty member at Point Loma Nazarene University in their Masters of Kinesiology program. Prior to obtaining her Doctor of Physical Therapy degree, Megan worked as an athletic trainer at Point Loma Nazarene University. Megan Kemp practices in our Manhattan office.
One of the great things about being a physical therapist at Excel Physical Therapy is the commitment that all of our clinicians have to life long education. This philosophy of commitment to growing and learning benefits us as clinicians, you as patients, and the Bozeman community as a whole. It is one of the things that allow Excel PT to impact our community in such a positive way and offer the best care we possibly can.
As a spine specialist trained in manual orthopedic therapy, I treat my fair share of cervical spines. It is one of my favorite things to treat. It is interesting and complex. Manual therapy is hugely beneficial for a variety of cervical diagnosis. These diagnosis can include cervical stenosis, cervical discs, cervical radiculopathy, upper cervical dysfunction, headaches and even dizziness related to general cervical dysfunction better known as cervicogenic dizziness. One of the things I enjoy most is resolving dizziness related to cervical dysfunction. Anyone who has dealt with a bout of dizziness knows how uncomfortable and debilitating it can be. It is so helpful to have this skill as a physical therapist so I decided to start thinking about how I could start addressing dizziness from a variety of origins not just cervical dysfunction.
This interest of mine as well as the need I saw in the community, resulted in me flying to Atlanta and enthusiastically participating in the Emory University Vestibular Rehabilitation Competency Based Course. This course is the gold standard in vestibular continuing education. It is an intense, evidence-based course designed for physical therapists, occupational therapists and MD’s with experience treating patients with vestibular deficits.
Participants who successfully achieve the Emory University Certified Vestibular Specialist designation successfully complete a practical exam, a written exam and a video exam demonstrating assessment skills including an oculomotor exam, balance assessment, gait assessment, fall risk assessment and other functional assessments. Participants also demonstrate appropriate treatment procedures for benign paroxysmal positional vertigo (BPPV) affecting posterior, anterior and horizontal canals for both cupulolithiasis and canalithiasis, for unilateral and bilateral peripheral vestibular disorders, and for central vestibular disorders including traumatic brain injury, concussion and stroke.
What does all of this mean? If you have dizziness, vertigo, balance problems or a variety of other issues resulting in this type of discomfort, you can come to Excel Physical Therapy, located at 19th and College streets in Bozeman, for relief and treatment by a highly trained physical therapist. We have a customized “vestibular room” with all the necessary equipment for accurate diagnosis and treatment including infrared goggles. I look forward to working with our clients who will benefit tremendously from this specialized physical therapy remedy that has very successful outcomes.
Bobby Bemis, DPT, COMT, DIP.MT, FAAOMPT is a fellowship-trained physical therapist at Excel Physical Therapy. Bobby specializes in orthopedic manual physical therapy of the cervical, thoracic and lumbar spine. Although the spine is his specialty, Bobby has a high level of training in all regions of the body. After receiving his undergraduate degree, Bobby earned a Doctorate in Physical Therapy, became a Certified Orthopedic Manual Therapist (COMT), Diplomat of Manual Therapy (Dip. MT), as well as becoming certified in trigger point dry needling. Bobby then went on to become Fellowship trained and was then designated as a “Fellow” with the American Academy of Manual Physical Therapy (AAOMPT) after passing a rigorous oral and practical exam. Only a very small percentage of physical therapists achieve this elite status. The “Fellow” is a physical therapist who has demonstrated advanced clinical, analytical, and hands-on skills in the treatment of musculoskeletal orthopedic disorders and is internationally recognized for their competence and expertise in the practice of manual physical therapy. Bobby achieved an Emory University Certified Vestibular Specialist designation due to advanced training and examination from the Emory University Vestibular Rehabilitation Competency-Based Course.
Excel Physical Therapy is very pleased to announce that Bobby Bemis, DPT, COMT, DIP.MT, FAAOMPThas achieved an Emory University Certified Vestibular Specialist: 2019 designation due to advanced training and examination.
The Emory University Vestibular Rehabilitation Competency-Based Course is the gold standard in vestibular continuing education. The course is an intense, evidence-based course designed for physical therapists, occupational therapists and MDs with experience treating patients with vestibular deficits. Participants who successfully complete this course will complete a practical exam, a written exam and a video exam demonstrating assessment skills including an oculomotor exam, balance assessment, gait assessment, fall risk assessment and other functional assessments. Participants also demonstrate appropriate treatment procedures for Benign paroxysmal positional vertigo (BPPV) affecting posterior, anterior and horizontal canals for both cupulolithiasis and canalithiasis, for unilateral and bilateral peripheral vestibular disorders, and for central vestibular disorders including traumatic brain injury, concussion and stroke.
Bobby is treating vestibular clients in the Excel PT Bozeman office, located at 19th and College streets, who are experiencing dizziness, vertigo, and balance issues. Specific treatment interests include Meniere’s disease, benign paroxysmal positional vertigo (BPPV), vestibular neuritis, ototoxicity, nystagmus, labyrinthitis, vestibular hypofunction, acoustic neuroma, concussion, stroke, and vestibular migraines.
Jackie Oliver, DPT, OCS and Matt Schumacher, DPT, OCS, MTC, CAFS, CSCS recently passed the rigorous Orthopaedic Clinical Specialist (OCS) examination in March 2019. Orthopaedics is the specialty dealing with the musculoskeletal system: bones, muscles, cartilage, tendons, ligaments and joints. This examination covered everything pertaining to orthopaedic physical therapy from head to toe. In order to sit for the exam one must have completed at least 2,000 hours of direct orthopaedic patient care within the last 10 years or have completed a post-professional residency in the field or orthopaedics.
The Orthopedics Clinical Specialist (OCS) advanced certification is coordinated by The American Board of Physical Therapy Specialists (ABPTS). The organization oversees a specialist certification process from the nine different specialties one can attain within the realm of physical therapy. The ABPTS mission is “to advance the profession of physical therapy by establishing, maintaining, and promoting standards of excellence for clinical specialization, and by recognizing the advanced knowledge, skills and experience by physical therapist practitioners through specialist credentialing.”
Under the ABPTS advanced certification programs, we at Excel Physical Therapyhave 1 Board-Certified Sports Clinical Specialist (Jason Lunden) and 3 Board-Certified Orthopaedic Clinical Specialists (Megan Peach, Matt Schumacher, and Jackie Oliver). As of 2018, there are only 86 Board-Certified Orthopaedic Clinical Specialists in the State of Montana, making this designation a well respected and prestigious title. Excel Physical Therapy’s team values incorporate investing in and encouraging advanced training and certifications for all of our physical therapy providers to help ensure excellent care and outcomes for our clients.
What do you think of when you hear physical therapy? Most individuals may have experienced or know of someone who experienced physical therapy with a pastinjuryor surgery. This is the bread and butter of what we do as physical therapiststhroughrehabilitating individuals back to what they love to do; however, most people do not know the benefits of seeing a physical therapist for “prehabilitation” or “wellness checkups” prior to a possible or potential injury from occurring.
Just as one goes to the dentist for a biannual checkup for prevention of possible future dental issues, physical therapy has and can be an option for the public in addressing possible musculoskeletal impairments, muscle strength deficits, and range of motion deficits in the body. As most of us all know, exercise has been suggested to aid in multiple health benefits such as preventing chronic disease, boosting mental health, increasing overall longevity, reducingrisk of cardiovascular disease, and improving bone health – just to name a few. As orthopedic physical therapists, we are trained and knowledgeable in rehabilitation and appropriate exercise prescription following injury and/or surgery, but we are also trained in injury prevention by providing patients and clientsresources for reducing their chance of an injury.
As spring is approaching and we are gearing up for the beautiful Montana summer, physical therapy may be of benefit to you or someone you know to increase your chances of a healthy, active, and injury-freeyear. It is typically easier to address these possible impairments before an injury may emerge versus after an injury has occurred. Most everyone, including you, may benefit from a “biannual checkup” with physical therapy!
Matt Schumacher, DPT, MTC, CAFS, CSCS received his Doctorate in Physical Therapy from the University of Mary in Bismarck, ND where he was recognized as a nominee for Outstanding Student Award in his physical therapy class demonstrating excellence in academics, volunteering, and servant leadership. Following graduation, he received training from Gray Institute with a Certification in Applied Functional Science (CAFS). Matt also completed a rigorous year-long program with Evidence in Motion (EIM) achieving his Manual Therapy Certification (MTC) gaining advanced training in mobilization and manipulation techniques for common diagnoses of the spine and extremities. Matt specializes in assisting individuals following post-operative rehabilitation, sports medicine rehabilitation, and orthopedic injuries/ailments of the spine and extremities utilizing advanced knowledge and skill with manual therapy and appropriate exercise prescription.
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.
"Megan helped me return to the activities I love after a badly broken leg. I am running, skiing, and biking again thanks to her!" -- L.S., Bozeman Patient
"Understanding Dizziness & Vertigo: How Vestibular Physical Therapy Can Help" @ Bozeman Public LibraryBobby Bemis, DPT, COMT, DIP.MT, FAAOMPT is a fellowship-trained physical therapist at Excel Physical Therapy. Bobby specializes in orthopedic manual physical therapy of the cervical, thoracic and lumbar spine. Although the spine is his specialty, Bobby has a high level of training in all regions of the body. After receiving his undergraduate degree, Bobby earned a Doctorate in Physical Therapy, became a Certified Orthopedic Manual Therapist (COMT), Diplomat of Manual Therapy (Dip. MT), as well as becoming certified in trigger point dry needling. Bobby then went on to become Fellowship trained and was then designated as a “Fellow” with the American Academy of Manual Physical Therapy (AAOMPT) after passing a rigorous oral and practical exam. Only a very small percentage of physical therapists achieve this elite status. The “Fellow” is a physical therapist who has demonstrated advanced clinical, analytical, and hands-on skills in the treatment of musculoskeletal orthopedic disorders and is internationally recognized for their competence and expertise in the practice of manual physical therapy. Bobby achieved an Emory University Certified Vestibular Specialist designation due to advanced training and examination from the Emory University Vestibular Rehabilitation Competency-Based Course.
