Excel Physical Therapy‘s Physical Therapy team will be on the field during the Blitzz FC Yellowstone Kick-Off Classic 2015 soccer tournament to help with on field medical needs and injury screens. Look for our flag and booth. We’re here to help!

Community Education Series – free and open to the public – join 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.

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.

Friday, June 20, 2014

Montana Ale Works from 3-6pm

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!

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.

Proper Computer Ergonomics for a Healthy Neck & Back

Using computers have become a normal part of most people’s daily lives.  For many of us, sitting at a desk top or laptop computer can last several hours every day.  Do you suffer from neck pain, upper back pain, or headaches?  Could poor posture at the computer be a contributing factor to such complaints? A 2012 study (Cho et al) found that 254 surveyed Chinese office workers, between 25 and 40 years old, working 3+ hours per day at the computer, had a 71%-76% prevalence of neck pain and a 60%-64% prevalence of upper back pain.       

 How often do we find ourselves stuck in postures such as this?  Poor positioning, most often producing a forward head, causes undue stress on the neck and upper back muscles and joints.  Over time, the soft tissues cannot bear the burden without developing tightness and inflammation.  Such complaints lead to pain and a visit to the physical therapist, massage therapist, or doctor in search of relief.

 A proper desktop set-up starts with a higher quality supportive computer chair, which securely supports the lower back lordosis, has great deal of adjustability, and comes with padded arm rests (forearm rests on padding).  A large computer screen, with the top edge placed just above eye level, is optimal.  The keyboard and mouse should be easily accessible to the hands so that the elbow can rest under the shoulder.  The ultimate goal is to have the ear, shoulder, elbow, and hip almost in a perfect vertical line.

 If the top of your desk is too high, then your keyboard and mouse can be placed on an adjustable external tray that is secured underneath this surface.  Obtaining proper ergonomics can be a good deal more challenging with a laptop computer, but purchasing an external keyboard and mouse or a laptop stand can be helpful.  These and other computer ergonomic products can be found online at ergopro.com

If you have specific questions about how to improve your computer ergonomics, contact David Coletta, MPT, CMPT at Excel Physical Therapy, 406-556-0562 in #Bozeman, Montana.

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

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

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

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.

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.