406.556.0562 Bozeman
406.284.4262 Manhattan
info@excelptmt.com
from Outside Bozeman "All Systems Go" - Tips for Injury-Free Ski Season
Tips for an injury-free ski season from Excel Physical Therapy’s AJ Sobrilsky and Jason Lunden
Preventing Falls & Improving Balance Talk with Jackie Oliver, DPT, OCS
Preventing Falls & Improving Balance Talk
Presented by Jackie Oliver, DPT, OCS, on Zoom
Community Virtual Event – Free & open to the public
Zoom recording link: http://bit.ly/3qCZjwW
Q: I fell yesterday walking and I have fallen a lot. All I can think of is, I am not picking up my feet enough? When I hit a crack or something I hit my toe and fall forward.
A: Sometimes that can be a strength thing, maybe your body is not strong enough, not that you can’t do it, but as you fatigue when you’re walking, you’re not lifting your feet as high because you are getting tired. So, your endurance might not be there in the lower extremity. It can be a multitude of factors…it could be your proprioception in the bottom of your feet aren’t picking up the cracks. A physical therapy evaluation can assess exactly what is causing your balance issues. As we get older, we tend to have balance issues that happen a little easier. We definitely don’t want you falling, especially outside on the hard concrete, that’s not a great place to be falling. Definitely worth a mention to your doctor or physical therapist about what you are experiencing so a plan can be put into place to help address this issue for you.
Q: I am someone who is dealing with peripheral neuropathy in my legs and feet, what do I do? Also, I am not able to lift my feet high enough when walking due to peripheral neuropathy.
A: So what you will want to do is uptrain like we talked about in that pie chart. We talked about a third, a third, and a third for vision, vestibular and peripheral neuropathy. The pie chart section that focuses on peripheral neuropathy is closing because you don’t have the sensation in your feet anymore. So you have to uptrain those other systems in order to compensate for the proprioception loss. Yes, it’s absolutely trainable. Not being able to lift your feet high enough is a strength thing, with peripheral neuropathy, you’re not going to change the peripheral neuropathy, you’re going to uptrain those other systems. It’s like a muscle making those other systems stronger, so you aren’t worried about the peripheral neuropathy impact as much.
Q: Is there somewhere we can access the charts that you were talking about?
A: The whole presentation will be loaded onto the Facebook page and the Excel website with the slides. (coming soon)
Q: What would you recommend as a call assist company for around your neck so if you fall you can get assistance?
A: With a little research online or by talking with family or friends, you can find one that will work with you. Recommendation given about Apple watch that asks if you have fallen and sends GPS tracking on where you are at if you don’t answer.
Q: Is there a booklet or something we can get with a detail view of different exercises we can build on for helping with resistance to falling?
A: A physical therapist can help determine a customized exercise program to help you with this. Also, tai chi, like yoga, is a great program to help with significant help on falling, some research showing up to 3 times a week has helped. Talk to your physical therapist, because we can have different deficiencies because you may be deficient in your quads and hamstrings somebody else may be deficient in their glutes. You may struggle with lifting your feet up and somebody else will struggle when they start doing head turns so getting a really specific exercise program is probably the best advice, so you’re not wasting your time so you’re not working on exercises you don’t need to work on.
Q: Does Medicare cover balance training?
A: Yes, Medicare does cover balance training during a physical therapy appointment.
Q: Do you have suggestions on footwear?
A: Making sure you are in a footwear that you are comfortable walking in. Something that isn’t bulky or has a high heel on it or has a big thick sole on it where you can get it caught on cracks in sidewalks. Flip flops, sandals in the Summer time are going to be hard to justify because they can slip on feet and effect balance. Specific footwear would be something to talk to your physical therapist to get headed in the right direction.
Q: Height of chair seat for a sit to stand desk?
A: There is a standard height, generally the measurement is dependent on height of the person using the desk. A physical therapist can help you determine the ideal measurements best suited for your positioning needs.
Q: Balance with a new hearing aid?
A: Vestibular system is a big part of our balance system that contributes to balance and having a new hearing aid can throw of your balance because things are different for you.
Jackie Oliver, DPT, OCS 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. She was fortunate enough to complete her clinical rotations and begin her physical therapy career within the University of Utah system, which is consistently ranked near the top in healthcare. Exposed to a wide variety of orthopedic conditions, Jackie is confident when assessing and treating a broad range of orthopedic impairments. Jackie is a certified dry needling provider with advanced training from Evidence in Motion and KinetaCore. Jackie achieved the Orthopedic Clinical Specialist advanced certification after extensive advanced training coursework and a stringent examination process from the American Physical Therapy Association.
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.
Treating Chronic Pain by Megan Kemp, DPT, ATC, CSCSAre 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. |
Our COVID-19 Policy Requests-Precaution and PreventionDear valued clients,
Your health and well-being are of the utmost importance to us at all times. Excel Physical Therapy and Massage is carefully monitoring local and national COVID-19 developments, which have moved us to implement policy in an effort to do our part for our clients, staff and community.
Here are our two COVID-19 policy requests:
Excel Physical Therapy and Massage already has an existing best practice of frequent hand and wrist hygiene before and after each patient encounter, sanitizing and disinfection of equipment, all common areas, and hard surfaces several times per day throughout both clinic locations. We are further increasing our vigilance in these efforts for all staff members and following CDC guidelines.
Here are the CDC’s recommended preventative protocols for additional precaution and prevention:
For the vast majority of people, COVID-19 results in a mild illness. However, there are certain populations with underlying health issues that can experience a more impactful illness. Because we have some patients who are more vulnerable, the above policies being implemented are for their safety.
We are here for you! Our Bozeman and Manhattan teams are happy to help you with all of your physical therapy and massage therapy needs. As always, your physical therapist is available through email or phone and we encourage you to communicate with them regarding your care.
Appointment planning. If you need to postpone future clinic appointments because you are sick for any reason or because of our high-risk travel quarantine request policy, then please call us at your very earliest opportunity as we have clients on our waiting list for appointments. More than 24 hours’ notice for canceling is preferable, but less than 24 hours will be accepted during this time.
Thank you for your patience with our precautionary efforts. We are in this together.
Take good care,
All of us at Excel
Bozeman team: 406-556-0562
Manhattan team: 406-284-4
Physical Therapy as a Means for Prevention 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.
Exercise Induced Muscle Cramps: Kind of a Big Dill
You know the feeling. You can see the finish line but you can’t get there because of a sudden onset of a muscle cramp in your calf that is demanding you stop. Dehydration and electrolyte imbalance were originally thought to be the cause of muscle cramping; the current theory is one of central regulation. In other words, muscle fatigue or stress create an imbalance in signals from the muscle to the central nervous system. As a result, the central nervous system alters motor neuron control and signals the muscle to continue to contract resulting in a cramp. Factors thought to be related to exercise induced muscle cramps include prolonged activity, muscle fatigue, increased exercise intensity, high levels of static stretching prior to exercise, and multiple high intensity workout days prior to competition. Muscle cramps often resolve as spontaneously as they occur, and usually within a few seconds to a couple of minutes. Suggested treatment of a muscle cramp includes rest, prolonged stretching with the muscle at full length, and pickle juice! You might think that pickle juice is related to electrolyte imbalance, but a new theory suggests that certain molecules in pickle juice (or other pungent foods) attach to receptors in the mouth and upper GI tract that are directly connected with the central nervous system. These receptors help the central nervous system to reduce the signal to the cramping muscle, therefore diminishing the cramp and your discomfort. So the next time the end is in sight but a muscle cramp is holding you back, grab your pickle juice. Because finishing a race is an accomplishment – it’s kind of a big dill.
Murray B. How curiosity killed the cramp: emerging science on the cause and prevention of exercise-associated muscle cramps. AMAA Journal 2016; Fall/Winter: 5-7.
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.
BSD7 Running Camp Workshop helps raise funds for Bozeman Schools FoundationMegan Peach and Jason Lunden were honored to offer a private Running Injury Prevention Workshop for Bozeman School District employees this month in our Bozeman office. We hosted this 2 hour workshop for a nominal fee and raised $186. The Excel Physical Therapy leadership team chose to donate this total amount, paid by district employees, to the Bozeman School Foundation in honor of the inspiring and dedicated teachers and staff of Bozeman School District.
Giving back to our community is important to the entire Excel Physical Therapy team and a key part of our mission and core values. Learn more how we support our community in other ways here: https://excelptmt.com/our-team/community/
Noisy NecksI am frequently asked about whether it is normal for a neck to make a lot of noise. Some of the more common adjectives I hear from patients describing these sensations are creaking, grinding or crinkly noises…the kind of noises you hear on the inside but are not generally audible to others. The short answer is yes, some increase in neck noise is to be expected as we age. However, certain noisy necks deserve a bit more attention.
To clarify, the noisy necks described above should be distinguished from other common neck noises including popping, cracking, clicking or snapping sensations in the neck. The importance in this distinction is that the former is most likely associated with normal wear and tear as long as there is not pain associated with the noise, where the latter may indicate some problems brewing in your noisy neck. Necks that tend to pop a lot, especially those that need to pop to relieve tension or pain, are likely experiencing increased stress in the joints and/or disc at the level of the popping. This should be seen as a warning sign. For the owner of that noisy neck, there is likely some degree of asymmetry in the mobility of the joints in the neck. This can lead to degeneration of those segments of the cervical spine that may lead to more problems than just neck noise down the line.
If your noisy neck is associated with pain and/or ever increasing stiffness and loss of mobility then you should consider consulting with your Physical Therapist. While some loss of motion in you neck is common with aging, especially in your later 60’s and beyond, earlier onset of a significant loss in mobility could be a tipping point for your neck. Many folks who bring this up during a physical therapy appointment are relieved to learn that certain neck noise is normal. In situations where neck noise may be indicative of a neck that’s going south, taking action and making a plan may really make a difference in your quality of life a few years around the bend.
Matt Heyliger, DPT of Excel Physical Therapy completed his Doctorate in Physical Therapy at Eastern Washington University in Cheney, Washington. He has a particular treatment focus in the relationship of cervical/thoracic spine mechanics and upper extremity conditions. An avid rock climber, telemark/backcountry skier and mountain biker, Matt regularly practices yoga and enjoys frequent adventures in the mountains with his family and their two labs.
Physical Therapy Can Help with Balance and Fall PreventionAccording to the APTA website, one-third of people over the age of 65 and up to half of people over the age of 80 will end up falling this year. Falls can diminish your ability to lead an active and independent lifestyle. Decreased balance and increased risk of falling are two things that inevitably come with aging. Fortunately, there is something you can do about it.
Balance has contributions from three sources; the inner ear, the feeling on the bottom of the feet, and your vision. If anyone of these is affected it can really decrease your balance. For example, if you suffer from macular degeneration that affects your vision or diabetic neuropathy that affects your ability to feel the bottom of your feet, then you may be at greater risk of falling. Other contributing factors include age, lower extremity weakness, using a cane or other walking device, medical conditions like stroke or Parkinson’s disease or a history of previous falls. If you have any of these risk factors and are concerned about falling, then physical therapy can help.
Physical therapists are highly trained professionals that can conduct balance assessments to determine if you are at an increased fall risk. If the screening shows that you are at risk, we can design a program tailored to your specific needs to help decrease your risk of falling. Strength, gait, range of motion and balance are all things that may be included in your plan of care to improve balance.
Staying active is one of the best ways to reduce your risk of falling. Yoga, gardening, Tai Chi or a regular walking program are all things that have been shown to increase a person’s confidence levels, improve body awareness and improve balance. Falling or fear of falling should not simply be accepted as a normal aspect of aging. A lot can be done to improve balance and keep you functioning at your highest possible level and physical therapy can help you get there.
– Jackie Oliver, DPT is a physical therapist at Excel Physical Therapy in Bozeman and Manhattan, Montana.
Posture Matters! Seminar 10/5/2016 @ Bozeman LibraryCommunity Education Series | Free & Open to the Public
seating limited to first 100 attendees
David Coletta, MPT, CMPT specializes in the treatment of back and neck pain, spinal issues, whiplash, headaches, TMJ/jaw pain, postural dysfunctions and professional bike fitting. As the founding owner of Excel Physical Therapy, David established Excel PT in 2001 on the principles of specialization, advanced education and customer service. He enjoys finding long-term solutions for his patients — solutions that involve a fine-tuned combination of manual manipulative therapy and a targeted exercise program that address even the most difficult patient presentations.
"I love Excel, I tell everyone if they need PT to come here. The level of care and knowledge is outstanding. I'll never go elsewhere for PT needs. (David)"--K.S., Bozeman Patient
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