David Coletta's Personal Bout with Acute Neck Pain: Lessons Learned Part 3

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

My Personal Bout with Acute Neck Pain: Lessons Learned ~ Part 3 of 3

Lessons Learned

I believe that there was a silver lining or a purpose to why I experienced this cervical radiculopathy.  As health care practitioners, we sometimes lose perspective on the severity of what our patients are dealing with.  The terrible pain, decrease in function, and loss of sleep will be hard to forget.  I gained valuable familiarity with the use of a Saunders Cervical Traction Unit and other treatments that are best for an acute and sub-acute radiculopathy.  I also became more personally familiar with the use of different medications to treat this condition.

Perhaps the most valuable lesson learned was an appreciation for how important good physical therapy and excellent physician specialty care are.  I would not be where I am today without the tremendous care from Megan and Effie (my physical therapists), Dr. Slocum, and the doctors at Bridger Orthopedics and Sports Medicine.  Hands on manual therapy, exercises, diagnostic imaging, and epidural steroid injection were all very helpful to me.

This ordeal has helped me to be a better physical therapist when treating the neck.  I value the experience over any class or formal education in my past.

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

Click Here to read David’s Bout with Acute Neck Pain: Recovery ~ Part 2 of 3

Youth Sports Injury Seminar for Parents, Coaches and Athletes Ages 18 & Under - 9/12/13 6:30pm

By Jason Lunden, DPT, SCS
jason@excelptmt.com

Join us for Excel Physical Therapy’s Fall 2013 Community Education Series Seminar

“Why Do Kids Get Injured? A Youth Sports Injury Seminar for Parents, Coaches and Athletes Ages 18 & Under”

Thursday, September 12, 2013

6:30-7:30pm

Bozeman Public Library Community Room

free and open to the public

Jason Lunden, DPT, Specialist in Sports Physical Therapy, presents a free talk that will focus on the following:

  • Latest updates for recognizing and treating concussions in youth ages 18 and under
  • How to recognize risk factors for non-contact injuries
  • Identify resources for injury prevention in youth sports such as soccer, football, baseball, skiing, lacrosse, etc.
  • Q&A time with Jason for your specific questions
  • Drawing for iTunes gift cards and more!

 

For more info: info “at” excelptmt.com or excelptmt.com/seminars

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. He has published on the topic of shoulder biomechanics and the rehabilitation of knee injuries and has a strong commitment to educating others. Jason serves as a physical therapist for the US Snowboarding and US Freeskiing teams and is a frequent, well-received local and national presenter on the topics of sports rehabilitation and injury prevention. He is a recent recipient of the New Horizon Award from the American Physical Therapy Association and he as received advanced training in dry needling techniques for the extremities.

Pregnancy and Exercise Tips by Megan Peach, DPT, CSCS

By Megan Peach, DPT, OCS, CSCS
megan@excelptmt.com

Just in case you missed our most recent library presentation on pregnancy & exercise, here’s a recap with some helpful tips for exercising while pregnant!

 

Pregnancy is an incredible time in a family’s life with LOTS of changes for everyone involved and LOTS of questions about the unknown. As an expectant mother myself, I realized that not a lot of guidance exists regarding exercise during pregnancy. With a little research, here’s what I found:

 

Exercise during pregnancy can be beneficial for both mother and baby, however you must check in with your prenatal care provided prior to beginning an exercise program and also regularly throughout your pregnancy to ensure the health of you and your baby. Benefits of exercise during pregnancy can include reduced risk of premature labor, reduced swelling, reduced risk of gestational diabetes & preeclampsia, decreased low back pain, and increased regularity of the digestive system.

 

The American College of Obstetrics and Gynecology recommends 30 minutes of daily exercise of moderate intensity for healthy pregnant women. Examples of moderate intensity are walking 3-4 miles per hour (15-20 minute miles), light swimming or cycling, and light resistance exercise. Can you maintain a conversation while exercising? If so, you are likely exercising at a moderate intensity.

 

Water walking or aerobic water exercise is a good option as water exercise can decrease force across joints as well as prevent an harmful rise in core temperature. Resistance and core exercises are appropriate during pregnancy provided that resistance is kept low (preferably body weight only) with high repetitions, and no sit-ups! Yoga is a great alternative to traditional core exercises although some positions may have to be modified to accommodate your growing belly and you should avoid inverted positions after 32 weeks gestation. Don’t forget the Kegels! It’s important to maintain your pelvic floor strength with kegel exercises during pregnancy to help prevent incontinence and to support the pelvic floor as it becomes stressed with the weight of the growing baby.

 

Some general advice for exercising during pregnancy:

  • Warming up and cooling down may be even more important during pregnancy than before to redistribute blood flow to working muscles in preparation for exercise.

  • Due to weight gain, changes in center of mass and balance, and hormonal fluctuations, exercise during pregnancy may feel different from exercise prior to pregnancy.

  • Listen to your body and stop if you feel discomfort! It’s important to stop exercise immediately if you experience the following signs and symptoms and contact your care provided should symptoms persist: dizziness, headache, chest pain, calf pain or swelling, bleeding, pre-term labor, amniotic fluid leakage. The farther along you are you are in your pregnancy, the more you may have to decrease the intensity and/or duration of exercise depending on your energy levels.

  • Pay attention to hydration, heat stress, fatigue, & exercise intensity as these may change from one week to the next.

Without a doubt, exercise during pregnancy has substantial benefits to mother & baby provided it is practiced safely. Please do not hesitate to contact your prenatal care provider should you have questions regarding exercise & your pregnancy!

 

Benefits of exercise during pregnancy can include reduced risk of premature labor, reduced swelling, reduced risk of gestational diabetes & preeclampsia, decreased low back pain, and increased regularity of the digestive system.

 

If you have any specific questions, contact Megan Peach of Excel Physical Therapy at 406.556.0562 in our Bozeman office.

 

 

Be Part of a Headache Research Study

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

Excel Physical Therapy Participates in a Research Study on Cervicogenic Headaches

 

Seeking Research Study Participants

Headaches can cause lost time from work, visits to multiple physicians, and a general loss in quality of life.  The major categories include migraine headaches, tension headaches, TMD headaches, and cervicogenic headaches.  While cervicogenic headaches are not the most common type of headache, the prevalence in the general population is estimated at 15%.

Cervicogenic headaches are defined as one sided, or one side dominant, head pain, which is caused by a neck problem.  Other symptoms include stiffness in the neck, decreased range of motion in the neck, increased headaches with neck movements or poor cervical postures, and a possible history of trauma.  Although physical therapy can be effective in treating tension headaches and TMD related headaches, cervicogenic headaches have shown, in multiple studies, excellent response to manual therapy.  Mechanical joint and muscle restrictions in the neck lead to a referral of pain into the head (cervicogenic headache).  Manual therapy based physical therapy utilizes hands-on techniques to restore muscle and joint mobility, eliminating the head pain. 

Interestingly, research indicates that manual therapy success in treating cervicogenic headaches does not depend on chronicity. Cervicogenic headache patients can benefit from manual therapy treatments whether the symptoms have been present for 20 days or 20 years!  As a manual physical therapist for 15 years, my success rate with treating cervicogenic headaches has been very high. Our research from this study hopes to clinically show which manual therapy techniques are the most effective for treating cervicogenic headaches.

Excel Physical Therapy is enrolled as a clinical site in a national research study to determine the best manual therapy techniques to treat cervicogenic headaches.  There are several other clinical sites throughout the United States also collecting data on real patients being treated in a physical therapy environment.  Mobilization or manipulation of the neck and upper back are the two manual therapy variables in this study.  Mobilization is a joint “popping” technique and mobilization is a joint “stretching” technique. 

The Treating PT at our clinical site is skilled and trained in performing both spinal mobilization and manipulation.  One treatment group will receive only manipulation and the other treatment group will receive only mobilization and exercise.  We anticipate that both groups will benefit from the manual therapy treatments, but the magnitude of improvement is part of our research question.  Both groups will have 6 physical therapy visits over 2 to 4 weeks.

We are looking for patients to be part of this study – To be included:

  • patients must have one side dominant head pain, pain in the neck or the base of the skull that is felt to project into the head, and at least one headache per week for at least 3 months. 

  • Patients cannot be included in the study if they have a history of stroke, high blood pressure, high cholesterol, diabetes, heart disease, peripheral vascular disease, smoking, or whiplash injury to the neck in the last 6 weeks. 

  • Patients are not being offered free treatments in this study.  As with all of our patients, cost for physical therapy services will follow our normal fee schedule and we are happy to bill your insurance or provide you with a payment plan.  In most cases, a doctor’s prescription is not required to receive physical therapy services in Montana.  Excel Physical Therapy is a preferred provider for many insurance companies as well.

 

Please contact me if you meet the criteria for this study or if you have any questions.

David Coletta, MPT, CMPT -Treating Physical Therapist

david at excelptmt.com (insert the @ sign in your email message)

406-556-0562

Headaches Can Be a Pain From The Neck - May 3, 2012 Seminar

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

“Headaches Can Be a Pain From the Neck”

Self-Help Techniques and Treatment Options

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

 

As featured on KBZK TV, “Montana This Morning” with Jeff Kelly

 

Thursday, May 3, 2012

6:30-7:30pm

Bozeman Public Library Community Room

Community Education Series – free and open to the public

 

What You Will Learn:

  • The various types of headaches that originate from

    neck problems

  • Understand why you are suffering from headaches.

  • Learn what to do when you experience headache pain with simple exercises, treatment options and suggestions to self-treat.

  • Q&A session to follow.

David Coletta, MPT, CMPT specializes in the treatment of back and neck pain, spinal issues, whiplash, headaches, TMJ/jaw pain, and postural dysfunctions. 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 advanced training has occurred through the North American Institute of Orthopedic Manual Therapy (NAIOMT). He has completed advanced certification in manual therapy (CMPT) with NAIOMT, and he is working towards his Orthopedic Clinical Specialist (OCS) certification with the American Physical Therapy Association.

Tension Headaches - Most Of Us Will Experience One

By Tiffany Coletta
tiffany@excelptmt.com

by David Coletta, MPT, CMPT

It has been a long stressful day and you can feel your head getting tight, like it’s being squeezed in a vise. The pain in your head becomes bad enough that you pop some ibuprofen and go to bed early. Sound familiar?

Tension headaches are included as one of the major classifications in the all too common world of head pain. Other types of headaches include migraines and cervicogenic headaches. A study by Haldeman (2001) found that 78% of adults will experience tension headaches once in their lives. This type of headache can range from the isolated incident that is illustrated above, to people who have severe and unrelenting tension headaches.

A tension headache is described as pain on both sides of the head (often in the temples and the back of the head), pressing and tightening in quality, with tenderness in the muscles on the sides of the head and on the base of the skull. The source of chronic tension headaches is poorly understood, but many researchers think that there is a link between dysfunctional brain interpretation of pain and the muscles of the head and upper neck becoming hypersensitive.

How do you treat tension headaches when they become more than just the limited occurrence, which is resolved quickly with over the counter medication? A visit to your general physician or a neurologist and trial of prescription medication is a good starting place. However, some patients don’t find adequate relief with medication. I would advise that the next step should be an appointment with a physical therapist specializing in headaches and neck dysfunctions. The physical therapist will be able to thoroughly evaluate your neck, head, and posture to determine if chronic poor postures and strain to the head and neck is present. Often, improving posture and showing the patient gentle stretching exercises will lead to a reduction in tension headaches.

david@excelptmt.com

Excel Physical Therapy

Bozeman 406.556.0562

Manhattan 406.284.4262

Headaches Can Be a Pain From the Neck

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

Headaches Can Be a Pain From the Neck

by David Coletta, MPT,CMPT

Headaches can take on many forms and be the source of major disability in the general population.  20% of all visits to a Neurologist in the United States are made because of headache complaints.  Major classifications of this diagnosis include migraines, tension headaches, and cervicogenic headaches.  As a physical therapist, specializing in the evaluation and treatment of musculoskeletal dysfunctions, I am particularly familiar with the cervicogenic headache.

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TMJ Dysfunction – What is it and how can it be treated?

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

TMJ Defined

Temporomandibular Joint (TMJ) Dysfunction is a disorder of the joint where the jawbone meets the skull or the muscles surrounding that region. People suffering from TMJ Dysfunction complain of popping or locking in the jaw, pain in the face with eating or opening the mouth, and headaches. TMJ Dysfunction can be further classified into joint dysfunction, myalgia, or a combination of dysfunction and myalgia. Myalgia is simply defined as intra-muscular pain. Pure joint dysfunction of the TMJ involves popping in the jaw, pain coming from joint structures (bone, cartilage, disc, ligaments, joint capsule), and a predictable and measureable loss in mouth opening or closing range of motion. Myalgia in the TMJ region relates to inflammation and dysfunction in the muscles surrounding the TMJ. These muscles can cause local facial pain, neck pain, headaches, and changes in how the jaw is actively moved. Combined joint dysfunction/myalgia of the TMJ is the most common presentation and can include all of the elements in the individual disorders previously described.

TMJ Dysfunction – What is it and how can it be treated?

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

Underlying Causes

It is important to explain some the underlying reasons for TMJ dysfunction. The most obvious cause is a serious blow to the face or jaw, disturbing the normal biomechanics of the joint.  However, more common causes include chronically poor posture, stress-induced grinding of the teeth or clinching the jaw, malocclusion of the teeth (high or low tooth), and neck pain or trauma to the spine.  My experience has been that over 90% of patients that I treat, with the diagnosis of joint dysfunction or myalgia of the TMJ, present with dysfunctions of the neck.  These patients require a careful evaluation of the neck and treatment that includes joint mobilization or manipulation, soft tissue massage, and exercise to improve posture and restore pain-free jaw active range of motion.

TMJ Dysfunction – What is it and how can it be treated?

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

Treatment

As with any orthopedic problem, the most important step in treating TMJ Dysfunction is to obtain the proper diagnosis by a specialist. Some physical therapists, dentists, and medical doctors are specialty trained in TMJ Dysfunction. Myalgia is the easiest presentation to resolve and treatment can involve simple self-massage exercises, range of motion exercises, nonprescription anti-inflammatory medication, and ice/heat to the face. Treating joint dysfunction of the TMJ involves exercises to re-educate joint motion and fabrication of an oral appliance (acrylic splint) to fit over the teeth, altering joint motions and forces. I would suggest that only specialist dentist fabricate an oral appliance. These devices are expensive and often have to be remade when a dentist who does not understand the intricacies of TMJ fabricates them. Combined joint dysfunction/myalgia requires the combination of treatment approaches.

I went to three other PT clinics, two orthopedic surgeons, and several other practitioners before I was referred to you. In a few short weeks at your clinic, my neck and back pain is dramatically improved, I understand my problem, and now have the correct exercises so that I can help myself.”-Bozeman Patient

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