5 Things I'd Like You to Know Before Your First Visit

By Bobby Bemis, DPT, COMT, DIP. MT, FAAOMPT
bobby@excelptmt.com

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: 

  1. 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.  
  2. Come with an open mind. Try to put aside any prior experiences you have had with the healthcare system.  
  3. 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.  
  4. 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.  
  5. 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! 

 

excel-LOGO-X

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. 

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.

 

"Got to Keep on Moving" by Matt Heyliger, DPT

By Matt Heyliger, DPT
matt@excelptmt.com

I have recently been thinking quite a bit about the importance of joint mobility, not strictly for function, but for joint health. In manual therapy, assessment of a given joint in the body always consists of consideration of joint mobility. Is there enough mobility? If not, why not? Does the joint itself have a motion restriction? Or is there perhaps some tissue outside the joint, like a tight muscle, that is limiting mobility? While it makes sense that a certain degree of motion is important for functional tasks, like bending your knee a certain amount to ascend stairs, mobility is also critical for joint health. (more…)

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.

Attention Jaw Clenchers! 4/27/11 Seminar: TMJ Dysfunction/Jaw Pain: Helping Yourself with Specialized Physical Therapy

By Tiffany Coletta
tiffany@excelptmt.com

On April 27th, 2011, 6:30-7:30pm, Join Certified Manual Physical Therapist, David Coletta, MPT, CMPT at the Bozeman Public Library, Community Room for a discussion of “TMJ Dysfunction/Jaw Pain: Help Yourself with Specialized Physical Therapy”.

David Coletta, MPT, CMPT

Learn the source of your facial pain and headaches, as related to jaw muscle imbalance and joint dysfunction of the jaw and the neck.  Learn how to treat yourself with some simple exercises and techniques and how a specialized physical therapist can specifically help you.  Q&A with David to follow so you can ask specific questions regarding any jaw, facial pain or headaches.

 

David Coletta, MPT, CMPT is a certified manual physical therapist through NAIOMT and for over 14 years has specialized in treating facial pain, TMJ dysfunction, headaches, and neck pain.  Coletta is the owner of Excel Physical Therapy in Bozeman and Manhattan, Montana which is celebrating their 10th year of service to the Gallatin Valley this year.

 

To sign up for future seminar announcements, join our e-list @ www.excelptmt.com.

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.

"All was great, very good experience all around. Thank you for all your help!" -- C., Bozeman Client"

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