Physical Therapy as a Means for Prevention 

By Matt Schumacher, DPT, MTC, CAFS, CSCS
matts@excelptmt.com

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 past injury or surgery. This is the bread and butter of what we do as physical therapists through rehabilitating 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, reducing risk 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 clients resources 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-free year. 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! 

 

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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. 

5 Things I'd Like You to Know Before Your First Visit

By Bobby Bemis, DPT, COMT, DIP. MT, FAAOMPT
bobby@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: 

  1. 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.  
  2. Come with an open mind. Try to put aside any prior experiences you have had with the healthcare system.  
  3. 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.  
  4. 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.  
  5. 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! 

 

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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. 

Your Chronic Low Back Pain Could Be Instability of the Spine Lurking in the Shadows

By David Coletta, MPT, CMPT
david@excelptmt.com

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While 80% of all US citizens will experience some level of low back pain during their lives, 10.2% (2006 US Survey) of all adults in this country have suffered from chronic low back pain that limits activity for an extended period of time.  As a physical therapist that specializes in treating the spine, I often have chronic low back pain patients that struggle to understand why their condition exists.  Many clients arrive for an evaluation after years with severe bouts of low back pain that comes and goes with minimal cause or explanation.  Trips to the doctor for medication, days missed from work, and visits to various types of practitioners are common with this diagnosis. My experience has found that some of these chronic low back pain patients have spinal instability as the source of their condition. 

Spinal instability or excessive vertebral segmental motion is a possible cause of chronic low back pain.  General wear and tear, previous injuries, and congenital abnormality of the vertebrae can be factors that lead towards instability.  Looking at the spine with the muscles removed, there is a beautiful structure that is present which allows for movement, but also provides stability from one spinal segment in relation to its neighbor (above or below).  The discs, ligaments, and vertebrae themselves provide this passive stability.  Compromise to these structures can lead to instability or an excessive amount of movement.  The muscles of core and deep spine provide protection and smooth movement between the vertebrae and the low back in general, which is termed dynamic stability. When passive stability is lacking, dynamic stability is in greater need.  However, dynamic muscular stability of this level is often lacking in spinal instability patients.  With these individuals, acute low back pain bouts arise when an activity, such as shoveling snow or even bending over to pick up a pencil from the ground, overloads the available passive and dynamic stability.

Perhaps the most common form of low back instability is an anterior spondylolisthesis or a slippage forward of a lumbar vertebra in relation to the vertebra below it.  This diagnosis can be picked up through a detailed and specific physical therapy evaluation and then confirmed with a specialized x-ray of the lumbar spine.  A spondylolisthesis has various grades, depending on the degree of slippage measured on the image. A mild or even moderate spondylolisthesis is best treated with specific core stabilization exercises and teaching the patient how to safely lift, given this diagnosis.  Higher grades of spondylolisthesis may require surgical spinal fusion to stabilize the segments. Many patients go years or decades without understanding the true source of their chronic low back pain.  In some cases, instability or spondylolisthesis is the culprit lurking in the shadows.

 

As the founding owner of Excel Physical Therapy, David Coletta, MPT, CMPT strives for our clinics to deliver unprecedented excellence with patient care in the Gallatin Valley. David established Excel PT in 2001 on the principles of specialization, advanced education and customer service. David specializes in the treatment of back and neck pain, spinal issues, whiplash, headaches, TMJ/jaw pain, and postural dysfunctions. 

A considerable amount of David’s advanced training occurred through the North American Institute of Orthopedic Manual Therapy (NAIOMT). He has completed advanced certification in manual therapy (CMPT) with NAIOMT, and he has received advanced training in dry needling techniques for the spine and extremities. David is a Certified Clinical BikeFit Pro Fitter.

Making Sense of Back Pain Seminar @ Bozeman Library

By Bobby Bemis, DPT, COMT, DIP. MT, FAAOMPT
bobby@excelptmt.com

Community Education Series | Free & Open to the Public

“MAKING SENSE OF BACK PAIN: what you’re doing wrong for back pain

presented by Bobby Bemis, DPT, COMT, Dip. MT, FAAOMPT

Thursday, October 11, 2018 | 6:30-7:30pm

Bozeman Public Library Community Room

  • What we are doing wrong with back pain as a society, as a healthcare system, and as individuals.
  • Why not all back pain is the same and why that is so important to understand.
  • Learn how to take the correct steps to control and manage your back pain in a healthy way.
  • Why MRI’s and x-rays may be sometimes misleading.
  • Learn practical exercises, movements, and modifications to help your pain and dysfunction.
  • Low back pain from all age populations will be discussed.
  • Q&A with Bobby after the talk.

Back pain is the most common complaint U.S. healthcare professionals receive daily. Come hear Bobby Bemis, a fellowship-trained orthopedic physical therapist through the American Academy of Manual Physical Therapy, discuss back pain and how you can find the pain relief you seek.

Bobby Bemis, DPT, COMT, Dip. MT, FAAOMPT 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 from the University of Colorado, Bobby earned a Doctorate in Physical Therapy from Regis University in Denver, Colorado. Post-graduation, Bobby 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 through the Institute of Manipulative Physiotherapy and Clinical Training (IMPACT). Bobby was designated as a “Fellow” with the American Academy of Manual Physical Therapy (AAOMPT) after passing a rigorous oral and practical exam. 

Conquering Low Back Pain Seminar 10/17/2018 @ Nogan's Cafe in Manhattan

By Jackie Oliver, DPT
jackie@excelptmt.com

Community Education Series | Free & Open to the Public

“Conquering Low Back Pain

presented by Jackie, Oliver, DPT

Wednesday, October 17, 2018 | 6:00-7:00pm

Nogan’s Cafe – 220 Wooden Shoe Lane in Manhattan

  • Understand anatomic sources of low back pain.
  • 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.

Welcome Bobby Bemis, DPT, COMT, DIP. MT, FAAOMPT!

By Tiffany Coletta
tiffany@excelptmt.com

Welcome Bobby Bemis, DPT, COMT, Dip. MT, FAAOMPT to the Excel Physical Therapy team!

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 from the University of Colorado, Bobby earned a Doctorate in Physical Therapy from Regis University in Denver, Colorado. Post-graduation, Bobby 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 through the Institute of Manipulative Physiotherapy and Clinical Training (IMPACT). Bobby was 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’s philosophy consists of using knowledge, skill and experience to provide the best physical therapy possible to help his patients achieve their goals. 

Bobby enjoys cooking, reading, yoga, and adventuring through the mountains and rivers of the west with his Newfoundland, Clarence. 

EXPLANATION OF INITIALS:

DPT: Doctorate of Physical Therapy

COMT: Certified Orthopedic Manual Therapist– A certification that focuses on advanced, localized, and specific spinal/peripheral manipulation techniques. Designed to teach therapists how to effectively manage the difficult patients that most therapists struggle with. This certification is a distinction given to Manual / Manipulative Physical Therapists around the world who have completed post-graduate specialization in the field of neuro-muscular skeletal disorders. The specialization includes “hands-on” techniques used to evaluate muscles, fascia, nerves, and joints.

Dip. MT: Diplomat of Manual Therapy – A certification demonstrating mastery in orthopedic manipulative therapy. It is an intensive training program with a comprehensive oral exam and written case reports. It requires advanced clinical reasoning, advanced theoretical knowledge and advanced technical skills. Only a very small percentage of physical therapists achieve this elite status.

FAAOMPT: Fellow in the American Academy of Orthopedic Manual Physical Therapy– 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. Only a very small percentage of physical therapists achieve this elite status.

What exactly is an orthopedic manual physical therapist? Orthopedic Manual Physical Therapy is any “hands-on” treatments such as moving a joint in a specific direction and at different speeds to regain movement (joint mobilization and manipulation), muscle stretching, passive movements of the affected body part, and selected soft tissue techniques used to improve the mobility and function of tissue and muscles. Orthopedic manual physical therapists treat conditions in body regions like the head, neck, back, arms and legs. Advanced examination, communication and decision making skilled that are built on the foundations of professional and scientific education facilitate the provision of effective and efficient care.

"The diagnostics, care and support had a tremendous impact and facilitated a strong and accelerated recovery - David is a Healer!" -- J.B., Bozeman Client

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