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 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.
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Dear 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:
- If you are sick for any reason, with a fever, cough or are sneezing, then we ask you to not return for clinic appointments until your symptoms fully resolve.
- If you travel to high-risk regions per the CDC, inside the US with specified community transmission (after clicking on the link, scroll down and then expand the plus sign next to States) or outside of the US that have a Level 3 Travel Health Notice (widespread, ongoing transmission), we are asking you to postpone attending clinic appointments until 14 days after your return date to the Gallatin Valley. This requested 14-day waiting period exists for symptom-free patients and is based on the current average of 5.1 days for the incubation period for symptoms to appear. Possible COVID-19 symptoms include fever, coughing, shortness of breath, or any combination of these complaints. If either of these requests create a hardship for you, please call us so your physical therapy provider can create a solution for you.
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
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.
What is physical therapy? How can it help me? What should I know? What role do I play in it? What if I don’t like going to the gym? Will it hurt? How do I know if I need it? What if I don’t like being touched? What if I don’t like exercising? Is it a quick fix? Maybe I should just get surgery? What if I can’t be helped? Maybe I just need to be tougher? Do I need therapy if my medication helps the pain?
I am guessing that if you are reading this article that you have asked yourself one or more of these questions before. Most of my patients have and it can be incredibly overwhelming. I am here to help you navigate the physical therapy world and maybe even a little of the healthcare world in general.
Full disclosure. I am biased. I love physical therapy. I love that a generally non-invasive form of healthcare can benefit so many. I love that like so many things in life you often get out what you put in. I love that physical therapists, in general, are empathetic, positive, altruistic people that want nothing more than to see people walk out of the clinic in a better place than when they came in. This blog is for those of you who aren’t quite sure what to expect regarding physical therapy and how you can take advantage of what it has to offer.
Physical therapy has undergone a major evolution over the past decades. Long gone are the years of using treatment time to primarily administer modalities (e.g. ice, heat, ultrasound, tape, etc.). No longer do we regard injuries as a purely physical experience and ignore all the other components of a person that can impact their pain and dysfunction. Physical therapists and hopefully other healthcare professionals now view patients in what is called a biopsychosocial framework. That means your pain is not only impacted by biological factors (e.g. arthritis) but psychological factors (e.g. anxiety) and social factors (e.g. a fight with your spouse). This framework continues to be supported by more and more high-level research from all over the healthcare world.
Physical therapists are musculoskeletal experts and gateway healthcare practitioners. What does that mean? When it comes to musculoskeletal issues you will be hard pressed to find another healthcare professional that is better at diagnosis and treatment of these conditions. As gateway healthcare practitioners physical therapists have the ability to see patients without a referral and we are educated on how to screen for other medical conditions that may not be appropriate for physical therapy. In these cases, we can refer to specialists that have expertise in the appropriate area of care.
Physical therapy can help you organize the complex and confusing world of today’s healthcare resources and options. Do you need to see a surgeon? Do you need to see a non-surgical orthopedic physician? Would you benefit from massage therapy? Would you benefit from consultation regarding a steroid injection? Could you benefit from some mental health counseling? Would a registered dietician be helpful? Or are you just where you need to be…in physical therapy?!
Here’s 5 suggestions/recommendations regarding your first visit for physical therapy:
- Come prepared. If you feel like you might be anxious, overwhelmed or nervous take the time to write out any questions you may have before your visit. That way you can refer to your notes when your mind goes blank.
- Come with an open mind. Try to put aside any prior experiences you have had with the healthcare system.
- Don’t get too fixated on imaging. Imaging is good at ruling things out but not great at ruling in things that are causing your pain. There is not a good correlation between tissue degeneration and pain…so be careful.
- Remember that all pain is perceived in your brain…so your pain can change depending on the state of your mind. There are techniques and strategies to address neurological pathways that may have developed over time that negatively impact your pain.
- Physical therapy is an active endeavor. It is very rare that a physical therapist can magically fix your pain or dysfunction in one visit. My goal is to get you back out there ASAP…but it will not happen overnight and will not be done passively.
One of the biggest complaints I hear from patients regarding health care professionals, in general, is that most don’t listen and they lack empathy. Keep in mind that as a physical therapist at Excel Physical Therapy, I have 45 minutes to do the best I can to figure out what is going on and how to best provide you with the tools to improve and get better. To steal a line from the psychologist and author Malcolm Gladwell we must use “thin-slicing” to help us figure out the best path for our patients. That means that a good therapist or healthcare practitioner will skillfully direct the conversation to get the information that will allow them to best figure out a plan of care that can best impact the patient for the better. We want to hear your entire story and we will…over time.
One of the beauties of physical therapy is that we spend more one on one time with patients than almost any other healthcare profession. If you are honest with yourself and take into account your biological, psychological and social factors that may bias your opinion toward your healthcare practitioner and you still feel like you are being treated without empathy or by an outdated biological model, simply find a healthcare practitioner that works better for you.
How can we help you? We are a specialized physical therapy practice that collaboratively provides the most effective manual, orthopedic and sports therapy treatments, allowing us to efficiently return patients to their highest level of comfort and functionality.
We deliver one-on-one, direct patient treatment by our licensed, specialty-certified physical therapists to ensure preeminent physical therapy services and patient care. We have served the Gallatin Valley since 2001 and are locally owned and operated by physical therapists.
At Excel Physical Therapy, our entire team–physical therapy team, massage therapy team, front office care coordinators and patient services assistants–ALL work very hard each day to welcome, listen and help you to feel better as a result of our evidence-based treatment plans and services. Your excellent outcome is our sole mission: Superior care from expert clinicians, supported by passionate staff, impacting the Gallatin Valley and beyond.
Thanks for taking that time to read my article. I hope you find this information helpful. See you at Excel PT!
Bobby Bemis, DPT, COMT, DIP.MT, FAAOMPT is a fellowship-trained physical therapist at Excel Physical Therapy. Bobby specializes in orthopedic manual physical therapy of the cervical, thoracic and lumbar spine. Although the spine is his specialty, Bobby has a high level of training in all regions of the body. After receiving his undergraduate degree, Bobby earned a Doctorate in Physical Therapy, became a Certified Orthopedic Manual Therapist (COMT), Diplomat of Manual Therapy (Dip. MT), as well as becoming certified in trigger point dry needling. Bobby then went on to become Fellowship trained and was then designated as a “Fellow” with the American Academy of Manual Physical Therapy (AAOMPT) after passing a rigorous oral and practical exam. Only a very small percentage of physical therapists achieve this elite status. The “Fellow” is a physical therapist who has demonstrated advanced clinical, analytical, and hands-on skills in the treatment of musculoskeletal orthopedic disorders and is internationally recognized for their competence and expertise in the practice of manual physical therapy.
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.
Community Education Series | Free
“Understanding Climbing Injuries: The Biomechanics Behind Acute and Overuse Injuries in Climbing”
presented by Matt Heyliger, DPT
Tuesday, January 29, 2019 | 12pm-1:30pm
Montana State University Climbing Gym in the Hosaeus Fitness Center
- Learn about the most common contributing factors to both acute and overuse injuries in rock climbing.
- Deepen your understanding of upper extremity anatomy and biomechanics.
- Learn self-care techniques that are critical to injury prevention and treatment.
- Learn how to safely re-introduce climbing after injury/rehabilitation.
- Discuss approaches to training for climbing including safe use of a hang board and campus board.
- Have questions? Q&A with Matt Heyliger, DPT after the talk.
Matt Heyliger, DPT is an avid climber and mountain sports enthusiast. His passion for climbing has taken him around the US, Canada and Mexico. Matt has a specific interest focus in biomechanics and how impairments at one level or joint affect other body structures. Matt has specialized in working with and treating rock climbers for more than 5 years. In the past year he has been able to broaden his approach to treating climbers through integrating video analysis and specialized biomechanical assessments in the Climbing Lab at Excel Physical Therapy.
Megan 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/
I 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.
According 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.
"All was great, very good experience all around. Thank you for all your help!" -- C., Bozeman Client"View more testimonials from Excel PT clients »