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. 

Noisy Necks

By Matt Heyliger, DPT
matt@excelptmt.com

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.

Posture Matters! Seminar 10/5/2016 @ Bozeman Library

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

Community Education Series   |   Free & Open to the Public

Posture Matters! Seminarpoor posture at work

Wednesday, October 5, 2016

6:30-8:00pm

Bozeman Public Library

Large Community Room

seating limited to first 100 attendees

Presented by David Coletta, MPT, CMPT

 

What You Will Learn:

  • Learn why your posture matters, how it can lead to health concerns, and what you can do to improve yours now.
  • Please bring your older kids! Learning to optimize posture at an early age can have life changing results.
  • With the popularity of personal electronic devices, poor posture is an increasing problem. People of all ages are at risk for developing a multitude of musculoskeletal problems, including neck pain, back pain, headaches, shoulder impingement, elbow tendonitis, thoracic outlet syndrome, TMD, etc.
  • Bring your questions! Q&A with David Coletta, MPT, CMPT during and after the talk.

 

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.

 

"What Is That Ringing In My Ears?" by David Coletta, MPT, CMPT

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

Although tinnitus, or ringing in the ears, can be a sign of serious brain pathology, tumors, and hearing loss, this condition can also be often diagnosed by your physician as idiopathic tinnitus.  Such a diagnosis indicates no known or verifiable cause to the ringing in your ears.  Ruling out the more concerning problems through brain imaging, neurological testing, and hearing tests is helpful, but often leaves the patient with no real answers about how to decrease or eliminate the annoying sound.  One theory regarding the source of idiopathic tinnitus centers on the musculoskeletal system as a trigger for ear ringing.  (more…)

"Conquering Neck Pain" Seminar | 12/3/2014 6:30pm

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

Community Education Series – free and open to the publicjoin us!

 

“Conquering Neck Pain: Self-Help Techniques & Treatment Options”

Presented by David Coletta, MPT, CMPT, Certified Manual Therapy Specialist

 

Wednesday, December 3, 2014

6:30pm-7:30pm

Bozeman Public Library Community Room

                                                                                                      

What You Will Learn:

  • How neck pain develops and becomes chronic.
  • What the anatomic sources of neck pain are.
  • How a specialized physical therapist utilizes manual therapy, patient education, exercise, and dry needling techniques to treat neck pain.
  • How improving posture can alleviate neck pain.
  • Which exercises are most effective in self-treatment of neck pain.
  • Other self-treatment techniques.
  • There also will be time at the end of the seminar to speak with David regarding your specific neck problem.

David Coletta, MPT, CMPT has specialized in the treatment of back and neck pain, spinal issues, whiplash, headaches, TMJ/jaw pain, and postural dysfunctions for over 15 years. David received his masters in physical therapy from Mount St. Mary’s College in Los Angeles, California. 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. A considerable amount of David’s training from leading physical therapy clinicians has occurred through the North American Institute of Orthopedic Manual Therapy (NAIOMT). He has completed advanced certification in manual therapy (CMPT) with NAIOMT and has received advanced training in dry needling techniques for the spine and extremities. David is also a Certified Clinical BikeFit Pro Fitter.

 

Advanced Training News...We're at it again!

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

David Coletta, MPT, CMPT, physical therapist and owner of Excel Physical Therapy of Bozeman and Manhattan, recently completed a seven day advanced spinal manipulation training from the North American Institute of Orthopedic Manual Therapy (NAIOMT). The course was held at Andrews University in Berrien Springs, Michigan, and was taught by Erl Pettman, PT, MCSP, MCPA, FCAMPT, a world leader in the development and education of safe and effective spinal manipulation.

  • At Excel PT of Bozeman and Manhattan, we are dedicated to providing our patients with the highest level of physical therapy treatment. Our physical therapists focus on evidenced-based practice, rigorous continued education in specialized areas of treatment, and weekly research-based study to allow our patients to quickly and effectively achieve the best results. To further ensure preeminent physical therapy services and patient care, each of our patients are directly treated by our licensed, specialty certified physical therapists – without interaction from assistants or aides.

Excel PT offering Free Bike Fitting Screenings at GVLT Longest Day of Trails 3-6pm

By Tiffany Coletta
tiffany@excelptmt.com

Friday, June 20, 2014

Montana Ale Works from 3-6pm

2014-LDOT-Poster-FINAL

David Coletta, MPT, CMPT and Jason Lunden, DPT, SCS of Excel Physical Therapy will be providing free Bike Fitting Screenings at the Longest Day of Trails Headquarters in Bozeman, Montana. Come by with your bike to learn how David and Jason can help fit your bike to your body. Reduce pain while riding as well as increase your cycling performance. Free Specialized water bottle with every free Excel PT Bike Fitting Screen!

Click Here for Excel Physical Therapy Professional Bike Fitting information.
 

This GVLT annual dawn-to-dusk (6am–10pm) bike-a-thon and membership drive takes places on the Friday in June nearest the Summer Solstice. It highlights GVLT’s work to expand, improve, and maintain our community trails. Headquartered at Montana Ale Works, the event features bike rides for all ages and abilities on Bozeman’s Main Street to the Mountains trails, with an evening celebration at Montana Ale Works and live music from Jawbone Railroad.

For a $35 donation to GVLT you receive a $5 gift certificate from Montana Ale Works and a wrist band to participate in the cycling activities. For a donation of $50 or more you will also receive a $5 gift certificate to Montana Ale Works, a wristband to participate in the cycling activities AND a gift certificate to a local retailer.

Click Here for more Longest Day of Trails event details and information.

David Coletta's Personal Bout with Acute Neck Pain: The Onset Part 1

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

My Personal Bout with Acute Neck Pain: The Onset ~ Part 1 of 3

The Onset

Evaluating and treating individuals with neck pain has been my specialty over the past 15 years.  I have literally treated over a thousand people suffering from this affliction.  Recently, neck pain became a much more personal issue, as I experienced the sort of agony which some of my patients deal with.  For the past 20 years, my neck has been intermittently stiff, with the occasional inability to turn my head for a day or two and what felt like an acute muscle spam, but there has been nothing of serious concern.  This was different.  While still in bed, I opened my eyes in the morning and noticed neck stiffness when turning over.  Could this be one of those mornings where there would be trouble turning my head?  Better to get up slowly.  I sat up and immediately felt a rush of nauseating pain sweeping into my low neck and then shooting into my left shoulder blade.  I don’t have time for this I thought.  Into the shower for some hot water on the neck and down the hatch with 600mg of Ibuprofen.  I drove to work applying traction to my neck with both hands and steering with my elbows and knees.  A smarter man would have just stayed at home and called in sick.  But I had patients that depended on me.

Luckily, this was my short day of the week at work.  My neck pain steadily grew worse and by 2PM I was stuck with my head down and turned to the right, avoiding the worst ache.  I utilized a home traction unit from work and had to go very slowly and gently not to aggravate my symptoms.  That night, I managed about 2 hours of sleep, constantly readjusting to avoid pain.

The next morning, I called a physician friend of mine and he prescribed me a round of oral steroids.   After 3 days, my neck pain slowly started to improve and within 1 week I was 75% better and training on my road bike for short periods.  Unfortunately, this progress did not last.

8 days after the initial onset, my symptoms suddenly returned in the morning and were even worse.  At this point I had to be honest with myself about the serious nature of my neck problem.  My symptoms included weakness in the left arm, severe pain behind the left shoulder and into the shoulder blade, severe neck pain, numbness in the left hand, and I could not extend my neck or turn to the right.  This was a very familiar presentation, a cervical radiculopathy.  It had to be a disc bulge in my low neck that was inflaming and compressing one of the spinal nerves.  Megan Peach, DPT, here at Excel PT did a great job at treating my acute problem, but my presentation was too severe to benefit from PT at that time.  I decided to make an appointment with a local orthopedic specialty physician. 

Click Here to read My Personal Bout with Acute Neck Pain: Recovery ~ Part 2 of 3

Click Here to read My Personal Bout with Acute Neck Pain: Lessons Learned ~ Part 3 of 3

 

David Coletta's Personal Bout with Acute Neck Pain: Recovery Part 2

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

My Personal Bout with Acute Neck Pain: Recovery ~ Part 2 of 3

Recovery

As a physical therapist specializing in treatment of the spine, I had a great deal of experience with the physicians at Bridger Orthopedic & Sports Medicine.  This seemed like a good place to seek advice and help for my agonizing condition.   I called Christine, a patient care coordinator at Bridger, and she was kind enough to get a same day appointment for me with Dr. Speth and Bryce Wiley, PA-C.  They performed a very thorough evaluation and determined that I most likely had a cervical radiculopathy.  I was in for a cervical MRI the next day and Bryce called to inform me that the imaging revealed a left C5/C6 disc bulge with compression on the C6 nerve root.  There was also some cervical arthritis present in the mid to low neck.

Again, the patient care coordinators (Christine & Shane) quickly scheduled me for a cervical steroid injection with Dr. Slocum at the surgery center, just below Bridger Orthopedics & Sports Medicine.  Dr. Slocum was kind enough to come downstairs between seeing patients and perform a transforaminal steroid injection in the neck.  During the procedure, I took the opportunity to dissect what was going on.  Some of my patients go through spinal injections and they will often ask me if it is painful.  Now I was about to find out.  I’m sure the experience is different for all people, but my procedural pain was considerable, though quite brief.  Dr. Slocum injected around C6 on the left and for about 5 to 6 seconds I felt all of the pain that I had experienced over the last week and a half condensed into my neck, shoulder blade, and arm.  Within a few minutes there was some relief.  Dr. Slocum explained that the injection could take 1 to 2 weeks for the full positive effect, but I would experience an initial decrease in pain within the first day, which might not last.

The next morning I woke up and felt 90% better.  I could move my neck, lie down comfortably on my back, and work on patients without concentrating on my own pain.  Slowly, by the next day this reduction in pain slid backwards to about 50% better.  I had a problem.  Two days later, I was to be on a flight to Chicago for a much anticipated PT continuing education course.  Bryce prescribed me another round of oral steroids and more hydrocodone for pain relief.  I made it to Chicago, wearing a soft cervical collar on the airplane to support my neck. 

I arrived at my continuing education course tired, now only 40% better, and unable to sit during the presentation.  I was truly blessed to be traveling with Jason Lunden, one of our sports specialist PTs from Excel PT, and sitting next to another experienced PT named Effie.  During the first break she looked at me and asked if I was OK.  She got the full story.  Effie said “I can help you.”  I immediately explained how serious this problem was and that I probably was not appropriate for hands-on PT treatment.  She assured me that her specialty was in spine.  Sounds familiar.  Effie performed left sided cervical and upper thoracic joint mobilizations, soft tissue techniques to the shoulder blade and shoulder muscles, and traction to the neck.  These techniques were more aggressive than I would have chosen for my patients, but I was willing to try anything and I trusted her.  After 10 minutes of treatment, my pain was reduced greatly and I practically fell asleep on the table.

Effie treated my neck again on the following 2 days of class and, by the time I returned home to Bozeman, the symptoms were improved to 75% of normal.  I continued under the care of Megan Peach, at Excel PT, and I reached 95% improvement over the next month with physical therapy treatments 2x/weeks.  The remaining 5% of symptom reduction and full strength in the left arm took 2 to 3 more months of performing my exercises independently.  

Click Here to read David’s Personal Bout with Acute Neck Pain: Lessons Learned ~ Part 3 of 3

Click Here to read David’s Personal Bout with Acute Neck Pain: The Onset ~ Part 1 of 3

"Jackie was super wonderful and helped my healing process immensely! She is extremely kind and intelligent and I would not have improved without her. Thank you!! :)" --K.L., Bozeman patient

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