Foot Pain
Older Posts »By Tiffany Coletta
Outside Bozeman's "Push & Pull: Essential Ingredients for Running and Climbing" by AJ Sobrilsky, DPT, OCS
By Tiffany Coletta
tiffany@excelptmt.com
Read the article here: https://bit.ly/2EUnvJ2
AJ is a physical therapist in Excel PT’s Bozeman clinic who uses specialized gait and the Excel PT Climbing Lab to help treat injury and provide skilled performance assessments.
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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.
The Answer Is Load, What’s The Question? by AJ Sobrilsky, DPT, OCS
By AJ Sobrilsky
aj@excelptmt.com


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.
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.
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!
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!
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.
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
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.




Schedule your next Excel Massage online at Schedulicity.com
By Tiffany Coletta
tiffany@excelptmt.com
Schedule when, how and from where it is most convenient for you! Convenient online scheduling for Excel Massage now available on Schedulicity.com. Click Here to schedule your next massage with James or Britnee. We’re only a phone call away too, 406.556.0562. |
Give the perfect gift with an eGift card
By Tiffany Coletta
tiffany@excelptmt.com
Sharing Running Training Principles from The Excel PT Running Camp
By Megan Peach, DPT, OCS, CSCS
megan@excelptmt.com




Excel Physical Therapy recently hosted our biennial Running Camp that reviewed the mechanics of running, training principles, and footwear to help you stay injury free during your summer running program. As it turns out, errors in training are responsible for up to 70% of running injuries. In case you missed it, here’s a re-cap of the training principles we discussed to help reduce the risk of injury:
- Avoid year-long training
- Avoid running more than 40 miles per week
- Train two or more but less than 5 days per week Rest days are important!
- Increase mileage by no more than 10% every 2-weeks
- Stretch daily to ensure normal joint mobility
- Do strength training exercises for your core 2-3 days per week
As runners, up to 90% of us will sustain an injury over the course of our running careers that temporarily prevents us from running. Proper training principles will help to reduce the risk of injury and improve your chances of a successful running program.
Megan Peach, DPT, OCS, CSCS specializes in manual treatment of spinal dysfunction, as well as knee and shoulder pain and is a member of the Excel Physical Therapy running specialist PT team. Megan’s philosophy for physical therapy treatment embraces educating patients about the tools they need for enhancement of proper body movements during work and play to promote a pain and injury free active lifestyle.




"I want to add my name to the long list of people who recommend EXCEL Physical Therapy. I was active in sports for 14 years and operated a building maintenance business for 30 years. I have developed a number of physical health problems over the years. David worked with me one-on-one to successfully treat a serious nerve problem which limited my ability to drive. David and his staff are among the finest therapists I have had the pleasure of working with. I highly recommend them to anyone who has physical health challenges and need the best care possible." --J.D., Bozeman Patient
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