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Spend Time Hanging and Start The Season Stronger - by Matt Heyliger, Excel PT Climbing Lab

By Matt Heyliger, DPT
matt@excelptmt.com

 
 

With the current state of things, many climbers who have not previously set up a hang board and/or training area at home are tackling these tools up at home and getting their hang on. Many others who had a routine of hanging at home prior to COVID-19 are back at it in full force. This is a great time to develop a more systematic approach to training. 

Through this experience, trial and error has revealed some key points to consider when hanging at home. First and most important, how do you pull off a proper warm up without a climbing wall? I strongly believe your home warm up needs to be systematic to properly warm up while gauging how you’re feeling on a given day. It’s vital here to let go of your expectations (and ego) and to honestly assess your recovery from your previous bout of training. Sometimes you realize you’re feeling a lot better than you thought as you progress through your warm up. And sometimes you feel heavy and weak when you expected to feel great. Listen to your body and respect the process. 

The first 20-25 minutes of your session should consist of a progression with light loading on larger holds trending toward the holds the given workout will emphasize. If you have the space and ingenuity to safely anchor a pulley set to offload some of your body weight (plenty of DIY info out there on this) this can be really helpful for warming up. For many this will enable you to train safely as your connective tissue in you fingers, hands and elbows adapt to this form of loading. You can also unweight your feet to progressively increase load keeping a little body weight on the floor, perhaps progressing to both or single tippy toe position.  

Start with a set of 2-3 minutes with 10 seconds on, 10 seconds off hold times on a large 4-finger pocket edge or a jug on the top of the board. This should feel fairly easy; you should feel warmth in the forearms and hands but not enough strain to develop a pump. Take an equivalent timed rest period, 2-3 minutes. During this time you should perform active warm up drills for the upper body, perhaps a few push- ups or pull-ups, anything to get the blood flowing in the shoulders and arms. Repeat another warm up set, now 3 minutes in duration, still 10 seconds on, 10 seconds off but increasing the load or perhaps starting to decrease the hold size. Change one variable at a time and see how things feel. At the end of this set, you really want to feel the forearms working, working up to 60% effort to complete the set. Rest an additional 3-4 minute while performing continued dynamic upper extremity warm up drills.   

For the last warm up set, I would recommend trending your on/off time to match the workout you are doing that day. A very common work out called repeaters involves 7 seconds on followed by a 3 second rest per rep. This set should be exclusively on the holds you are training on that day. I like to extend the rest time this set using 7 seconds on and 13 seconds off for the entire set to accommodate increased load. I find this fends off burning key energy needed for a successful workout while loading closer to the time and resistance for that given workout. This set should be 3 minutes and should be followed by a 5-minute rest prior to starting you workout for the day.  

If you haven’t spent much time hanging recently you may surprise yourself and start the season stronger and more durable.  

The Excel PT Climbing Lab exists to keep you climbing and improve your performance. We offer comprehensive injury management, video-based climbing analysis, and training plans. 

 

excel_faviconMatt Heyliger, DPT, COMT of Excel Physical Therapy completed his Doctorate in Physical Therapy at Eastern Washington University in Cheney, Washington and is a Certified Orthopedic Manual Therapist. He has a particular treatment focus in the relationship of cervical/thoracic spine mechanics and upper extremity conditions. Matt treats climbers through integrating video analysis and specialized biomechanical assessments in the Excel PT Climbing Lab in the Bozeman, Montana clinic. An avid rock climber, telemark/backcountry skier and mountain biker, Matt regularly practices yoga and enjoys frequent adventures in the mountains with his family.

 

 

 

 

 

Running Skills: A Talent Or Ability That Comes From Training And Practice - By AJ Sobrilsky & Jason Lunden 

By AJ Sobrilsky
aj@excelptmt.com

Who’s ever picked up a golf club and tried to knock it stiff from 130 yards out? That’s a tough feat to accomplish; a skill one might say. In fact, I’d argue that consistently hitting a golf ball where you want it to go and how you want it to look is one of the most difficult skills to develop.

That’s probably why most professional golfers, and high caliber athletes across the sports world, spend more time practicing and developing the skills of their specific sport than they do truly competing and playing. In fact, in David Epstein’s book “The Sports Gene,” there is a lot of discussion about practice, talent, and the genetics surrounding athletic performance. This is a highly recommend read or listen to if you’re looking for a good new book and it might help us all understand a little better our true capabilities and athletic realities (He also has a lot of podcasts as well as a Ted talk. Click here to listen

In the running world, there are those few individuals born with a unique physiological make up and a somewhat specific set of anatomical ingredients that lend them performance capabilities. But, that doesn’t mean there aren’t specific contributors to performance and skill development that can’t be modified, practiced, and fine-tuned to become your own best version of yourself. Sure the best runners are the ones spending a lot of time running and logging a lot of miles. Which leads a lot of us to come to the conclusion that in order to be our own best we need to run a lot. While increasing volume will improve your economy and times to some degree, it’s ultimately not the best solution. 

The old fallacy of more is better doesn’t hold true, at least not always. We can put time and effort into developing a bigger engine (cardio system, stronger muscles, more resilient mental game), but if we can’t control that engine and the forces it’s willing to produce, it’s useless. For instance, it’d be a bad idea to strap a jet engine onto a paper airplane or try to shoot a cannonball from a canoe. We need the right structure, skillset, and control to put these ingredients and tools to effective use. 

 

What do the best athletes in the world have in common (beyond the best genes)? They train, refine, retool, and practice the skills required for their specific activity. Unlike a lot of other sports, running doesn’t have a whole lot of diverse movements like soccer or climbing. This ultimately confines our exposure to different movements and limits our breadth of exposure and adaptability to forces outside the confines of the running gait. On the other side it also means we have a pretty consistent recipe or set of instructions for developing the best gait pattern and running movement strategy (all relatively dependent on our own unique set of factors). 

 

Jay Dicharry, a leading physical therapist and biomechanics researcher, delivers this message well when he says, “There are a lot of things that all runners of all abilities should be doing outside running to improve their running. If you want to run better, you need to move better”.  Essentially that the winner isn’t always the one who stacks up the most Strava KOM/QOM’s but rather the ones who have put time into developing and practicing the essential movement skills; allowing them to avoid injuries and ultimately providing optimal consistency in training.  

Running is essentially a fluid series of single leg jumps. The ability to produce enough force to drive your leg into the ground and propel yourself up and forward. To then coordinate the appropriate movements in the flight phase (while you’re going from step to step) in preparation for landing. And to then absorb 2-3 times your body’s weight through one leg, restoring that energy, and preparing to do it all over again in less than 0.4 seconds for each and every step throughout the duration of the run.  

 

So yes, running is a skill. What can you do to move better and become a more skilled runner? 

 

Before we dive into the specifics on the ingredients and tools required to address the skills of running, here are a few key essential components to practice during your next few runs:

 

  • Don’t Overstride: A lot of runners make the mistake of overstriding: putting their foot out too far in front of their center of mass. When a runner overstrides or reach, they increase their braking impulse and essentially slow themselves down with each strike. This is an inefficient way to run and significantly increases the amount of impact your body has to absorb. Therefore, overstriding can often lead to injury.  To avoid overstriding, avoid reaching your leg forward and try to strike just in front of your center of mass.
  • Cadence: Cadence is the number of steps you take while running. A slower cadence (or taking fewer steps per run) can be indicative of overstriding. Therefore, working on your cadence can be one way to improve your efficiency and reduce overstriding. Every runner will have a different cadence, but in general efficient runners run with a cadence between 176-188 steps/min. To work on your cadence, use a metronome app or setting on your watch and try and time your foot strikes to the beat of a metronome for 2-3 minutes. Then relax into your run for 2-3 minutes. Repeat 3-5x throughout your run.  Remember this is a drill to improve skill, so use it as a drill and don’t perform with every run or for your entire run.
  • Try not to bounce:  Much like overstriding, a bouncy gait is inefficient and can lead to injury. If you have a bouncy run, you are wasting energy pushing up rather than pushing forward. This also means your mass is landing from a higher height, increasing impact.  To avoid a bouncy gait, drive your leg back pushing you forward and not up. Centering your gaze on a landmark ahead of you and as you run try and keep the landmark as still as possible .
  • Drive from the hip and push from the ankle: The gluteus maximus is the biggest muscle in the human body. This is a big ingredient in the recipe to effectively and efficiently drive us forward with each step.  Sometimes runners rely too much on their calves and quads to propel them. This typically leads to overstriding and the bouncy gait described earlier. Therefore maximize your running efficiency by driving from the hip using the gluteus maximus; making sure not to arch at the lower back. Practice striding by driving/pushing from the glutes while stabilizing through your core to avoid your back from arching.

Here at Excel PT, Our running physical therapist team works with runners every day in our Running Clinic. It’s like a specialized clinic within a clinic. We’re here to help you develop these strategies to help improve your running skills and performance as well as help you prevent injury. 

 

 

excel_faviconAJ Sobrilsky, DPT, OCS is a Physical Therapist and Orthopedic Clinical Specialist in our Bozeman clinic.  AJ specializes in the rehabilitation and prevention of orthopedic sports related injuries with a specific interest in the management of those involving the upper and lower extremities. AJ has been a lifelong athlete, competing in cross-country and track through college and then racing competitively post collegiately. As a result of his personal experiences and passions, AJ has focused his continued education and clinical development around the athletic individual with an emphasis in: running, skiing, and climbing related injuries. AJ has had the opportunity to provide care for an array of athletic populations including youth sports teams, high school and collegiate athletes, and those competing at professional and Olympic levels.

 

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Jason Lunden, DPT, SCS specializes in the rehabilitation and prevention of sports-related injuries, with a particular interest in the biomechanics of sporting activities – running, cycling, skiing, snowboarding and overhead athletics in our Bozeman clinic. Jason is a Specialist in Sports Physical Therapy and serves as a physical therapist for the US Snowboarding and US Freeskiing teams, along with the US Paralympic Nordic Ski Team, and is a local and national presenter on sports rehabilitation and injury prevention topics. Jason is a Certified Clinical BikeFit Pro Fitter and co-owner of Excel Physical Therapy.

 

 

The Answer Is Load, What’s The Question? by AJ Sobrilsky, DPT, OCS

By AJ Sobrilsky
aj@excelptmt.com

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What unique times and circumstances we find ourselves in as climbers. The climbing gyms are closed, all the home gym products are sold out, and as a community we’ve put others best interest ahead of our passion and stayed local respecting the pleas to avoid traveling to popular climbing destinations. So it seems like no better time to take care of some essential preparation in our personal climbing dojos. What better time to begin or continue training, hone and establish an armor of strength, or finally address that “insert nagging climbing related ache here” you’ve had going on for months now. Whether you’re using a hangboard to strengthen those fingers, campusing to develop some power, or taking to the kettlebells and theraband to recover it all boils down to loading. 

 

Loading simply is stress applied to a tissue or structure (muscle, tendon, bone) that results in some type of adaptation (stronger, stiffer, smarter). Load can be a good and a bad thing. Load in excess goes beyond the tissues capacity to remodel and adapt and could potentially result in a reactive response or injury. In fact there really is no injury; acute, chronic, or traumatic that simply doesn’t boil down to loading beyond capacity. But uniquely enough in this situation the problem or cause is also the answer and solution.

 

There are many types, strategies, and forms of loading depending on our desired response: rehabilitative loading, adaptive loading, stimulus loading, and reactive loading. While for the purpose of this specific post we’ll solely reference load as a physical stimulus we must remember that load stimuli is also psychological (more on that in a future post). So the answer to both improving your climbing performance, taking care of that nagging injury, and building up that armor of injury resilience is loading. Rest is not the best, and yes if you don’t use it you will lose it (however there is a caveat and exception for acute traumatic injuries: ACL repairs, grade III pulley ruptures, or Rotator cuff and SLAP repairs where we need to respect a typical tissue healing timeline). But if you’re still convinced rest is what you need here’s a simple guide to help you with that. https://www.climbing.com/skills/unsent-how-to-be-injured/

 

Loading isn’t always an exact science. A lot of factors and contingencies are at play when it comes to determining the amount, type, duration, and frequency of loading. For instance, your current training phase, training age, training history, injury history, and long term goals will influence how we’d load differently from one climber to another. Whether you’re 2-3wks into an acute injury or 3-4months of consistent aggravating complaints would also impact the loading program.

 

Hopefully, this post provided some insight to continue, progress, or adjust your current training. Or maybe it was just a quick break between burns on your home board that you’ve finally had time to finish (or start building). So with all that here is a final few tips, key concepts, and strategies to consider when loading:

 

  • Gradually and slowly progress load – Probably the most important one! 
  • Variables to consider modifying with loading: volume, velocity, duration, loading positions (different grips) 
  • Vary the surface or position you’re loading in: tension block, flash board, hangboard, single rungs, different board systems or walls.  
  • Respect the recovery required to adapt from a specific training session and/or training cycle.
  • Develop climbing specific skills: climbing is a unique sport with an ever changing set of parameters required to complete and thus ever changing and adapting set of skills required to be successful. It’s one thing to be strong but it’s another to know how to harness that strength to achieve desired goals. 

Here at Excel Physical Therapy, we are ourselves climbers and patients as well as climbing research, training, and rehabilitation specialists. So we get it.  We understand what you’re going through, and we can help you figure out how to take the steps towards those climbing goals. We’d love to have you in person in the Excel Climbing Lab for a climbing evaluation, evaluate and establish a plan for that nagging injury, or consult for injury/performance questions via an in-clinic or telehealth appointment. We’re here for you and we’d love to keep providing more and more information on all things climbing so please let us know if there is anything specific you’d like to hear and learn about. 

 

excel_faviconAJ Sobrilsky, DPT, OCS is a Physical Therapist and Orthopedic Clinical Specialist in our Bozeman clinic.  AJ specializes in the rehabilitation and prevention of orthopedic sports related injuries with a specific interest in the management of those involving the upper and lower extremities. AJ received his Doctor of Physical Therapy Degree from Carroll University (Waukesha, WI). Following the completion of his DPT degree he participated in an Orthopedic Residency through Evidence in Motion at Bellin Health in Green Bay, WI providing him with advanced training in orthopedic manual therapy, clinical decision making, and patient centered treatment. Following completion of his residency AJ became an Orthopedic Clinical Specialist (OCS) through the American Physical Therapy Board Association and received advanced training in dry needling for spine and extremities.

AJ has been a lifelong athlete, competing in cross-country and track through college and then racing competitively post collegiately. As a result of his personal experiences and passions, AJ has focused his continued education and clinical development around the athletic individual with an emphasis in: running, skiing, and climbing related injuries. AJ has had the opportunity to provide care for an array of athletic populations including youth sports teams, high school and collegiate athletes, and those competing at professional and Olympic levels.

AJ’s treatment philosophy emphasizes a collaborative patient centered approach. Structured around the patient, supported by current best evidence, and coupled with specialized exercise/techniques, AJ hopes to educate the patient on their current issue and provide them with the best course of treatment to return to their previous/desired level of activity. 

When AJ isn’t working he is usually pursuing his next adventure: rock climbing, skiing, mountain biking, or running. 

 

Treating Chronic Pain by Megan Kemp, DPT, ATC, CSCS

By Megan Kemp
megank@excelptmt.com

 

Are you currently living in pain? Have you in the past? If so, you are not alone. 50 million American adults have chronic pain and chronic low back pain is the leading cause of work limitations in the United States. It is generally well known that physical therapy is used following surgery or an injury. Unfortunately, it is much less commonly known that physical therapy is an effective and successful option for treating chronic pain.  

Typically, when people are in pain their first thought is to stop moving. This is often magnified when an individual has been in pain for months, or even years. So, if movement hurts, how can you reduce pain by moving? In order to understand this, it is important to first outline some important principles.  

Our bones and soft tissue structures operate under two important laws: Wolfe’s law and the SAID (Specific Adaptations to Imposed Demands) principle. These laws both imply that our body will adapt to the specific loads you place on it. If you overload the structures, you will have pain. However, if you optimally load the structures (e.g. bone, muscle, tendons), they will improve in strength. By improving your body’s strength, you will in turn be able to move with less pain.  

Physical Therapists are also the experts on identifying faulty movement patterns. Everyone has specific ways they move to accomplish basic daily tasks – walking, getting up from a chair, etc. Unfortunately, our movement patterns are not always optimal. This may be due to muscle imbalances, poor motor control of stabilizing muscle groups or pain. By optimizing your body mechanics, you will be able to reduce microtrauma on certain structures and in turn reduce your pain.  

The physical therapists at Excel Physical Therapy are highly trained in manual therapy techniques. For certain types of pain, a hands-on approach of soft tissue massage and joint mobilization and/or manipulation is indicated to reduce your pain.  

Regardless of the type of pain you may have, we take on an active role in helping you achieve your goals in reducing your pain. Our goal is always to empower every patient that walks in our clinic and help them achieve their goals of pain-free living. We provide a specialized approach to physical therapy that provides the most effective treatments, allowing our patients to return to their highest level of function as quickly as possible.

We have been proudly serving the Gallatin Valley in both Bozeman and Manhattan since 2001. Call us today to schedule an appointment so we can help you too.

 

excel_faviconMegan Kemp, DPT, ATC, CSCS is a Physical Therapist, Certified Athletic Trainer, and a Certified Strength and Conditioning Specialist in our Manhattan clinic. She’s a Gallatin Valley native and graduate of Manhattan Christian High School and 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 specializes in the treatment of upper and lower extremity athletic injuries, with clinical experience treating both high school and collegiate athletes. Megan is passionate about helping athletes of all ages return to their desired activity and strives to use the most current evidence-based practice medicine coupled with her knowledge of biomechanics to help her patients reach their goals. 

The Runner’s Arch Nemesis by Megan Kemp, DPT, ATC, CSCS

By Megan Kemp
megank@excelptmt.com

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!

 

excel-LOGO-XMegan 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.


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. 

Deep Vein Thrombosis: Everything you need to know about diagnosis and prevention. 

By Jackie Oliver, DPT
jackie@excelptmt.com

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. 

 

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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.

 

Running Experts Forum 2019 • April 17th @ 6:30pm

By Tiffany Coletta
tiffany@excelptmt.com

Community Education Series – free and open to all 

 

Running Experts Forum

 

Join us for an interactive, moderated panel discussion with Bozeman’s running experts about ALL things running. Door Prizes!

 

Wednesday, April, 17, 2019

6:30-7:30pm

Bozeman Public Library Community Room

Follow this event on Facebook!

 

Panel discussion topics to include: 

Injury Prevention • Running mechanics • Training tips & techniques • Shoe selection • Foot strike pattern • Staying motivated • Answering your questions! 

 

Panel Guests:

  • Our first panel guest is a Montana State University distance coach! Hear a coach’s perspective on training, technique, and injury prevention.

  • 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. 

  • Jason Lunden, Sports Clinical Specialist, Physical Therapist and co-owner of Excel Physical Therapy 

  • Moderated by Megan Peach, Physical Therapist & Orthopedic Clinical Specialist at Excel Physical Therapy

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 our Facebook 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.

  

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. 

"Jackie and everyone else at Excel PT are excellent. They are professional, understanding and provide a lot of encouragement to 'keep at it'."--D.E., Bozeman client

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