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Treating Chronic Pain by Megan Kemp, DPT, ATC, CSCS

By Megan Kemp
megank@excelptmt.com

 

Are you currently living in pain? Have you in the past? If so, you are not alone. 50 million American adults have chronic pain and chronic low back pain is the leading cause of work limitations in the United States. It is generally well known that physical therapy is used following surgery or an injury. Unfortunately, it is much less commonly known that physical therapy is an effective and successful option for treating chronic pain.  

Typically, when people are in pain their first thought is to stop moving. This is often magnified when an individual has been in pain for months, or even years. So, if movement hurts, how can you reduce pain by moving? In order to understand this, it is important to first outline some important principles.  

Our bones and soft tissue structures operate under two important laws: Wolfe’s law and the SAID (Specific Adaptations to Imposed Demands) principle. These laws both imply that our body will adapt to the specific loads you place on it. If you overload the structures, you will have pain. However, if you optimally load the structures (e.g. bone, muscle, tendons), they will improve in strength. By improving your body’s strength, you will in turn be able to move with less pain.  

Physical Therapists are also the experts on identifying faulty movement patterns. Everyone has specific ways they move to accomplish basic daily tasks – walking, getting up from a chair, etc. Unfortunately, our movement patterns are not always optimal. This may be due to muscle imbalances, poor motor control of stabilizing muscle groups or pain. By optimizing your body mechanics, you will be able to reduce microtrauma on certain structures and in turn reduce your pain.  

The physical therapists at Excel Physical Therapy are highly trained in manual therapy techniques. For certain types of pain, a hands-on approach of soft tissue massage and joint mobilization and/or manipulation is indicated to reduce your pain.  

Regardless of the type of pain you may have, we take on an active role in helping you achieve your goals in reducing your pain. Our goal is always to empower every patient that walks in our clinic and help them achieve their goals of pain-free living. We provide a specialized approach to physical therapy that provides the most effective treatments, allowing our patients to return to their highest level of function as quickly as possible.

We have been proudly serving the Gallatin Valley in both Bozeman and Manhattan since 2001. Call us today to schedule an appointment so we can help you too.

 

excel_faviconMegan Kemp, DPT, ATC, CSCS is a Physical Therapist, Certified Athletic Trainer, and a Certified Strength and Conditioning Specialist in our Manhattan clinic. She’s a Gallatin Valley native and graduate of Manhattan Christian High School and 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 specializes in the treatment of upper and lower extremity athletic injuries, with clinical experience treating both high school and collegiate athletes. Megan is passionate about helping athletes of all ages return to their desired activity and strives to use the most current evidence-based practice medicine coupled with her knowledge of biomechanics to help her patients reach their goals. 

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. 

Jason Lunden, DPT, SCS attends US Ski & Snowboard Class at the USSA Center of Excellence

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

Jason Lunden, DPT, SCS, of Excel Physical Therapy, recently attended the US Ski & Snowboard Team Medical Emergencies in Skiing and Snowboarding (MESS) Course at the USSA Center of Excellence in Park City, UT. The course focused on concussion evaluation, management and rehabilitation, as well as athlete development for ski and snowboard athletes.   Jason is an owner and physical therapist with Excel Physical Therapy of Bozeman and Manhattan, and he volunteers as a physical therapist for the US Ski & Snowboard Teams.

Technique & the Prevention of Alpine Ski Injuries: Part 4

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

Nearly all injuries in alpine skiing are classified as traumatic, or due to a fall.  As mentioned earlier, under Strength & Injury Prevention, the majority of knee injuries in alpine skiing occur on the left knee.   Therefore it is important to work on your ski technique to be able to turn equally well to your right and left.  With the snowpack being shallower and conditions not yet epic, the early season is a great time to work on perfecting your turns.  Aim to stay balanced on your skis with your hips centered and perfect your turns to both sides.  A Professional Ski Instructor or coach can make all the difference, so take the time to perfect your technique by taking a lesson at one or our local ski resorts, or sign-up for coaching from a community ski team such as the Bridger Ski Foundation (BSF).

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Equipment and the Prevention of Alpine Ski Injuries: Part 3

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

To reduce your risk of injury it is important to make sure your bindings are properly mounted and maintained.  Your ski is effectively a long lever arm and if your ski does not release properly it will put a tremendous amount of force through your knee.  Therefore it is important to make sure your DIN is set properly, and to check that the release mechanism is working properly regularly.  Keep in mind that due to gender differences in strength and morphology, the DIN on women’s bindings should be set at 15% below the recommended universal setting.   So before you get out for your first turns of the season, check your equipment and get assistance from your local independent ski shop if necessary. (more…)

Strength and Injury Prevention in Alpine Skiing: Part 2

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

Developing and performing a proper pre-season/dry-land strengthening program can help to reduce your risk of injury and improve your performance.  Alpine skiing is unique in that it places equal demands on both sides of the body, as one has to be able to turn equally well to the right and the left.  Research has found that the left knee is most often injured in alpine skiing1.  Therefore it is important to compare the strength of your right and left legs to get the most out of your workouts.  (more…)

Winter Injury Prevention: Alpine Skiing, Nordic Skiing, & Snowboarding - Part 1

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

Winter Injury Prevention: Alpine Skiing, Nordic Skiing, & Snowboarding: Part 1

At Excel Physical Therapy, winter is often our busiest time of year; and with good reason, many of us choose to live here for our winter pursuits of skiing and snowboarding.  Unfortunately these sports have a high injury rate and can lead to serous injuries resulting in the need for surgery and extensive rehabilitation.  While one cannot completely prevent injuries in skiing and snowboarding, your risk can be reduced by following injury prevention guidelines.   This series of blogs will focus on injuries and their prevention for alpine skiing, snowboarding, and Nordic skiing.

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"Significant improvement - extremely positive therapeutic experience." --Bozeman Patient

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