Injury Prevention

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Nikki Kimball's Training At Home Advice

By Nikki Kimball
nikki@excelptmt.com

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Nikki Kimball ‘s PT training at home advice: Don’t forget the core! We are lucky in Bozeman, Montana to have enough space to continue walking, running, biking and skiing, at safe social distances, outside. That said, our ability to perform outdoor sports and activities can always be improved through exercises that can be done at home. Use this time to make a lasting habit of core exercise, sport-specific drills or body maintenance work (think foam rolling).

For runners, Molly Huddle has some great ideas in a recent Runner’s World online article: https://zcu.io/vPQ0

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Nikki Kimball, MSPT is a member of the Excel Physical Therapy running specialist PT team. Click here to learn more about the Excel Running Clinic.

Our COVID-19 Policy Requests-Precaution and Prevention

By Tiffany Coletta
tiffany@excelptmt.com

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:

 

  1. 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.
  2. 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

Welcome Nikki Kimball, MSPT to the Excel PT Team!

By Tiffany Coletta
tiffany@excelptmt.com

Excel Physical Therapy team is proud to welcome Nikki Kimball, MSPT to the team. One-on-one specialized physical therapy with the ultra running expert dedicated to helping people.

Nikki Kimball is a Physical Therapist, Runner’s World Health Advisory Board Member, 2008-2016, Professional Runner, and a RRCA Certified Running Coach.

Nikki specializes in the treatment in running injuries and has been treating runners since 1999. She graduated with her MS degree in physical therapy from Arcadia University in 1998 and won the school’s Health Sciences’ Alumni Achievement Award in 2017 for her work integrating professional running, physical therapy and advocacy for people with mental illness. She is certified in ASTYM soft tissue mobilization and in dry needling. She has been an expedition physical therapist for running events in Africa, China and India.

Prior to her professional running career, Nikki was a cross country skier and biathlete. She raced NCAA Division I for Williams College where she won the Alumnae Ski Award two times. In 2018 she won the Distinguished Alumni Award at Holderness School for her using her athletic achievements as a platform to provide service “for the betterment of humankind” in areas of advocacy for health care and gender equity. She is a three-time North American Ultrarunner of the Year and three-time United States Track and Field Association Ultrarunner of the Year. She has won 11 National Championship titles and has been named to 14 US National Teams across three athletic disciplines.

Nikki presents on exercise prescription and physical therapy at psychiatric and adventure sports medicine conferences on the west coast and Rocky Mountain states. She has spoken professionally about running and injury prevention on three continents and at the US Embassy in Beijing, China. She has published articles in major print sports magazines in Asia, Europe and the US, including 13 pieces on injury prevention for Runner’s World. She has appeared in various films including a starring role in the regional Emmy winning feature, Finding Traction

Her treatment philosophy is to combine her physical therapy training and continuing education with decades of practical experience as a high-level competitor and coach to achieve the best possible results, particularly in the realm of complex running injury. When not working or adventuring, Nikki enjoys archery, wire sculpting, and cooking at home with her friends and pets.

Call the Excel Physical Therapy Bozeman office, 406-556-0562 to schedule your physical therapy appointment with Nikki.

 

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!

 

excel-LOGO-XMegan Kemp, DPT, ATC, CSCS, a Gallatin Valley native and graduate of Manhattan Christian High School, 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 Kemp practices in our Manhattan office.


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. 

Deep Vein Thrombosis: Everything you need to know about diagnosis and prevention. 

By Jackie Oliver, DPT
jackie@excelptmt.com

A deep vein thrombosis (DVT) occurs when a blood clot or thrombus forms in one of your deep veins due to slow moving blood. Most often a DVT occurs in the calf or lower leg, however a DVT can also form in other regions of the body such as the arm. Learning what puts you at risk for developing a DVT, as well as being able to identify the signs and symptoms associated with this medical condition is important for prevention of more serious complications like a pulmonary embolism (blocking blood flow to the lungs).  

The signs and symptoms of a DVT can include swelling in the affected leg, usually in the calf. This will normally feel sore and tender to touch. You may also see redness and warmth associated with the swelling. The hallmark sign of a DVT is that the pain does not increase or decrease with a change in position. DVTs can mimic a musculoskeletal injury like a calf strain without other symptoms like swelling and redness. The thing to remember is that a calf strain would have a mechanism of injury or a specific onset, whereas a DVT would have a history of prolonged sitting or recent surgery.  

Risk factors that increase the likelihood of developing a DVT include: a recent surgery, prolonged bed rest, pregnancy, smoking, age or sitting for long periods of time like when you are driving or flying.

If you find yourself in one of these categories there are a few measures you can take for prevention: 

1.) Avoid sitting still for prolonged periods. If you do have to be sitting or immobile for prolonged periods such as long plane flights or being laid up in bed recovering from a surgery or sickness, try pumping your feet up and down to get your muscles working and the blood flowing in your legs. 

2.) Wearing compression stockings during periods of immobility can help decrease the risk of developing a DVT. Talk to your doctor or physical therapist about getting compression stockings for travel or after surgery. 

3.) Regular exercise can also lower your risk of blood clots. A new study published by the Journal of Thrombosis and Haemostasis states that participation in sports, regardless of intensity, can lower your risk of developing blood clots by up to 39%. Regular exercise also decreases your BMI, which can also lower your risk.  

If you think you have symptoms related to a DVT it is important to get it checked out at an Urgent Care or Emergency Department as soon as possible. Your doctor will be able to detect a DVT using compression ultrasonography and will treat accordingly. DVTs can be a serious health problem but knowing the signs and symptoms can help prevent complications. Discovered early, complications from DVTs are preventable and easily treatable. 

 

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Jackie Oliver, DPT has an intense passion for helping and educating others as well as preventative medicine. Because of her college sports background, she loves working with athletes, biomechanical training and sport injury prevention. 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. Jackie is a certified dry needling provider with advanced training from Evidence in Motion and KinetaCore. Jackie also leads our Work Site Solutions programs.

 

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

 

Join us for an interactive, moderated panel discussion with Bozeman’s running experts about ALL things running. Door Prizes!

 

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.

  

Your Chronic Low Back Pain Could Be Instability of the Spine Lurking in the Shadows

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

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While 80% of all US citizens will experience some level of low back pain during their lives, 10.2% (2006 US Survey) of all adults in this country have suffered from chronic low back pain that limits activity for an extended period of time.  As a physical therapist that specializes in treating the spine, I often have chronic low back pain patients that struggle to understand why their condition exists.  Many clients arrive for an evaluation after years with severe bouts of low back pain that comes and goes with minimal cause or explanation.  Trips to the doctor for medication, days missed from work, and visits to various types of practitioners are common with this diagnosis. My experience has found that some of these chronic low back pain patients have spinal instability as the source of their condition. 

Spinal instability or excessive vertebral segmental motion is a possible cause of chronic low back pain.  General wear and tear, previous injuries, and congenital abnormality of the vertebrae can be factors that lead towards instability.  Looking at the spine with the muscles removed, there is a beautiful structure that is present which allows for movement, but also provides stability from one spinal segment in relation to its neighbor (above or below).  The discs, ligaments, and vertebrae themselves provide this passive stability.  Compromise to these structures can lead to instability or an excessive amount of movement.  The muscles of core and deep spine provide protection and smooth movement between the vertebrae and the low back in general, which is termed dynamic stability. When passive stability is lacking, dynamic stability is in greater need.  However, dynamic muscular stability of this level is often lacking in spinal instability patients.  With these individuals, acute low back pain bouts arise when an activity, such as shoveling snow or even bending over to pick up a pencil from the ground, overloads the available passive and dynamic stability.

Perhaps the most common form of low back instability is an anterior spondylolisthesis or a slippage forward of a lumbar vertebra in relation to the vertebra below it.  This diagnosis can be picked up through a detailed and specific physical therapy evaluation and then confirmed with a specialized x-ray of the lumbar spine.  A spondylolisthesis has various grades, depending on the degree of slippage measured on the image. A mild or even moderate spondylolisthesis is best treated with specific core stabilization exercises and teaching the patient how to safely lift, given this diagnosis.  Higher grades of spondylolisthesis may require surgical spinal fusion to stabilize the segments. Many patients go years or decades without understanding the true source of their chronic low back pain.  In some cases, instability or spondylolisthesis is the culprit lurking in the shadows.

 

As the founding owner of Excel Physical Therapy, David Coletta, MPT, CMPT strives for our clinics to deliver unprecedented excellence with patient care in the Gallatin Valley. David established Excel PT in 2001 on the principles of specialization, advanced education and customer service. David specializes in the treatment of back and neck pain, spinal issues, whiplash, headaches, TMJ/jaw pain, and postural dysfunctions. 

A considerable amount of David’s advanced training occurred through the North American Institute of Orthopedic Manual Therapy (NAIOMT). He has completed advanced certification in manual therapy (CMPT) with NAIOMT, and he has received advanced training in dry needling techniques for the spine and extremities. David is a Certified Clinical BikeFit Pro Fitter.

Exercise Induced Muscle Cramps: Kind of a Big Dill

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

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.

 

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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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