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.

 

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! 

 

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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. 

How to Build Muscle Faster: Blood Flow Restriction Therapy

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

Blood flow restriction training (BFR) is a relatively new technique being used in physical therapy and gyms to increase muscle strength.  We have been using BFR therapy at Excel Physical Therapy with promising results.   BFR therapy utilizes compressive forces from a specialized blood pressure cuff to restrict venous blood flow from a muscle group while allowing for continued arterial blood flow to the muscle.   The result of the restricted venous blood flow is a state of ischemia to the exercising muscle.  Exercising in a state of ischemia seems to cause a physiological cascade that results in increased signaling that promotes muscle growth, even at lower loads on the muscle. 

Utilizing BFR under careful supervision of a physical therapist, allows one to prevent muscle atrophy and increase muscular growth and strength while recovering from injury or surgery.   BFR is not a panacea and therefore is just one component of a proper rehabilitation program.  The ability of BFR to stimulate muscle growth at lower loads of resistance make it a perfect modality to consider for the earlier stages of rehabilitation.   To learn more about BFR therapy and to see if it would be appropriate for you, be sure to ask your physical therapist here at Excel Physical Therapy

 

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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. Jason serves as a physical therapist for the US Snowboarding and US Freeskiing teams, along with the US Paralympic Nordic Ski Team, and is a local and national presenter on sports rehabilitation and injury prevention topics. Jason is a Certified Clinical BikeFit Pro Fitter.

Sharing Running Training Principles from The Excel PT Running Camp

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

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Excel Physical Therapy recently hosted our biennial Running Camp that reviewed the mechanics of running, training principles, and footwear to help you stay injury free during your summer running program. As it turns out, errors in training are responsible for up to 70% of running injuries.  In case you missed it, here’s a re-cap of the training principles we discussed to help reduce the risk of injury: 

  • Avoid year-long training 
  • Avoid running more than 40 miles per week 
  • Train two or more but less than 5 days per week Rest days are important! 
  • Increase mileage by no more than 10% every 2-weeks 
  • Stretch daily to ensure normal joint mobility 
  • Do strength training exercises for your core 2-3 days per week 

As runners, up to 90% of us will sustain an injury over the course of our running careers that temporarily prevents us from running. Proper training principles will help to reduce the risk of injury and improve your chances of a successful running program. 

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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. 

BSD7 Running Camp Workshop helps raise funds for Bozeman Schools Foundation

By Tiffany Coletta
tiffany@excelptmt.com

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/

Excel PT Running Camp 2018

By Tiffany Coletta
tiffany@excelptmt.com

Open registration starts May 10th, 2pm! Big Sky Wind Drinkers members may register April 26-April 30th.

Attendee’s of our May 9th, 2018 Running Strong Seminar at the Bozeman Library will also receive priority registration access. 

Excel Physical Therapy is hosting our annual Running Camp on Saturday, June 16, 2018, 8AM-12PM, at our new state-of-the-art Bozeman location. We are located at 1823 West College Street, (corner of South 19th and College). 

This comprehensive 4-hour workshop ensures you are running strong to avoid pain & injury. Your registration is reserved with a $10 donation. We will donate your registration amount to the Gallatin Valley Food Bank in your name. Waiting list: This event is limited to the first 30 participants who register. You may sign up for the waiting list via our eventbrite.com registration page which will contact you via email if space becomes available.

Our Running Camp is a way for our team to share what we are passionate about with our community-from treating runners in the clinic to providing running mechanics education to running the local trails ourselves.

Our Running Specialist PT Team will guide up to 30 participants, ages 18+, through:

  • A discussion of training principles to reduce the risk of injury, stretching and strengthening exercises to supplement your running program, and a discussion on cadence training. 

  • Running Mechanics instruction on how to decrease impact and increase efficiency.

  • Special Guest discussions with Mike Wolfe, professional ultra-runner/The Mountain Project owner; Erika Rauk, MS, RD, LN, Registered Dietician; and Curt Smith, Schnee’s Shoes Footwear Manager. Inspiration, Nutrition, & Gear!

  • Cadence retraining during a short local training run with our Running Specialist PT Team.

  • How to choose the correct running shoes and other helpful running gear.

  • Attendees will receive a running training program from our Running Specialist PT Team. 

  • Q&A time with our running experts and special guests.

  • Raffle prizes include a 60-minute massage appointment with Excel PT’s Tristin Lowe, LMT and 2 entries for the Sweet Pea Run 5K. We are proud sponsors of the Big Sky Wind Drinker’s Sweet Pea Run! Our running camp is designed to help get you in top running form for this annual early August Bozeman running tradition.

Presented by: Megan Peach, DPT, OCS, CSCS and Jason Lunden, DPT, SCS 

Our mission at Excel Physical Therapy is to support our community through service, education and promoting the value of health and well-being; the Excel Physical Therapy Running Camp is our commitment to you to provide you with the most up to date strategies for a successful running program. Your strongest miles are ahead of you! 

Running Camp 2017
Running Camp 2017
Running Camp 2017

"Great job! Felt well card for and that (my physical therapists) earnestly wanted me to get back all I had lost."  --K.H., Manhattan Patient

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