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.
If you run into any issues during your running program, a Running Clinic Evaluation can help you continue to run, pain-free.
During a Running Clinic Evaluation, we examine your biomechanics to identify abnormalities in your running form and weaknesses that can be the underlying pain or injury cause.
We will develop a personalized physical therapy treatment plan to address gait flaws and fine-tune your body for better running efficiency.
James Becker, PhD is an assistant professor at MSU in the Health and Human Development program. His research interests include biomechanical aspects of human performance and biomechanical factors contributing to orthopedic injuries and he has published numerous articles on running mechanics and running related injuries.
Erika Rauk is a registered dietician and also has a masters degree in exercise physiology and sports nutrition.
Nikki Kimball is an elite ultramarathon runner with numerous national titles, physical therapist and a longstanding member of the “Runners World” magazine advisory board.
Do you have a running question you’d like the panel to answer at the forum? Post your question on our Facebook event page. While you’re there, check out the Relax & Run Giveaway contest on ourFacebook and Instagram pages. Post a question, like/follow us and enter to win a free 60-minute Excel Massage!
Seating is limited to 100 attendees. For more information, contact Megan Peach, DPT, OCS, CSCS at 406.556.0562 or megan@excelptmt.com.
What is physical therapy? How can it help me? What should I know? What role do I play in it? What if I don’t like going to the gym? Will it hurt? How do I know if I need it? What if I don’t like being touched? What if I don’t like exercising? Is it a quick fix? Maybe I should just get surgery? What if I can’t be helped? Maybe I just need to be tougher? Do I need therapy if my medication helps the pain?
I am guessing that if you are reading this article that you have asked yourself one or more of these questions before. Most of my patients have and it can be incredibly overwhelming. I am here to help you navigate the physical therapy world and maybe even a little of the healthcare world in general.
Full disclosure. I am biased. I love physical therapy. I love that a generally non-invasive form of healthcare can benefit so many. I love that like so many things in life you often get out what you put in. I love that physical therapists, in general, are empathetic, positive, altruistic people that want nothing more than to see people walk out of the clinic in a better place than when they came in. This blog is for those of you who aren’t quite sure what to expect regarding physical therapy and how you can take advantage of what it has to offer.
Physical therapy has undergone a major evolution over the past decades. Long gone are the years of using treatment time to primarily administer modalities (e.g. ice, heat, ultrasound, tape, etc.). No longer do we regard injuries as a purely physical experience and ignore all the other components of a person that can impact their pain and dysfunction. Physical therapists and hopefully other healthcare professionals now view patients in what is called a biopsychosocial framework. That means your pain is not only impacted by biological factors (e.g. arthritis) but psychological factors (e.g. anxiety) and social factors (e.g. a fight with your spouse). This framework continues to be supported by more and more high-level research from all over the healthcare world.
Physical therapists are musculoskeletal experts and gateway healthcare practitioners. What does that mean? When it comes to musculoskeletal issues you will be hard pressed to find another healthcare professional that is better at diagnosis and treatment of these conditions. As gateway healthcare practitioners physical therapists have the ability to see patients without a referral and we are educated on how to screen for other medical conditions that may not be appropriate for physical therapy. In these cases, we can refer to specialists that have expertise in the appropriate area of care.
Physical therapy can help you organize the complex and confusing world of today’s healthcare resources and options. Do you need to see a surgeon? Do you need to see a non-surgical orthopedic physician? Would you benefit from massage therapy? Would you benefit from consultation regarding a steroid injection? Could you benefit from some mental health counseling? Would a registered dietician be helpful? Or are you just where you need to be…in physical therapy?!
Here’s 5 suggestions/recommendations regarding your first visit for physical therapy:
Come prepared. If you feel like you might be anxious, overwhelmed or nervous take the time to write out any questions you may have before your visit. That way you can refer to your notes when your mind goes blank.
Come with an open mind. Try to put aside any prior experiences you have had with the healthcare system.
Don’t get too fixated on imaging. Imaging is good at ruling things out but not great at ruling in things that are causing your pain. There is not a good correlation between tissue degeneration and pain…so be careful.
Remember that all pain is perceived in your brain…so your pain can change depending on the state of your mind. There are techniques and strategies to address neurological pathways that may have developed over time that negatively impact your pain.
Physical therapy is an active endeavor. It is very rare that a physical therapist can magically fix your pain or dysfunction in one visit. My goal is to get you back out there ASAP…but it will not happen overnight and will not be done passively.
One of the biggest complaints I hear from patients regarding health care professionals, in general, is that most don’t listen and they lack empathy. Keep in mind that as a physical therapist at Excel Physical Therapy, I have 45 minutes to do the best I can to figure out what is going on and how to best provide you with the tools to improve and get better. To steal a line from the psychologist and author Malcolm Gladwell we must use “thin-slicing” to help us figure out the best path for our patients. That means that a good therapist or healthcare practitioner will skillfully direct the conversation to get the information that will allow them to best figure out a plan of care that can best impact the patient for the better. We want to hear your entire story and we will…over time.
One of the beauties of physical therapy is that we spend more one on one time with patients than almost any other healthcare profession. If you are honest with yourself and take into account your biological, psychological and social factors that may bias your opinion toward your healthcare practitioner and you still feel like you are being treated without empathy or by an outdated biological model, simply find a healthcare practitioner that works better for you.
How can we help you? We are a specialized physical therapy practice that collaboratively provides the most effective manual, orthopedic and sports therapy treatments, allowing us to efficiently return patients to their highest level of comfort and functionality.
We deliver one-on-one, direct patient treatment by our licensed, specialty-certified physical therapists to ensure preeminent physical therapy services and patient care. We have served the Gallatin Valley since 2001 and are locally owned and operated by physical therapists.
At Excel Physical Therapy, our entire team–physical therapy team, massage therapy team, front office care coordinators and patient services assistants–ALL work very hard each day to welcome, listen and help you to feel better as a result of our evidence-based treatment plans and services. Your excellent outcome is our sole mission: Superior care from expert clinicians, supported by passionate staff, impacting the Gallatin Valley and beyond.
Thanks for taking that time to read my article. I hope you find this information helpful. See you at Excel PT!
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.
The Runner’s Arch Nemesis by Megan Kemp, DPT, ATC, CSCS
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.
