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Preventing Falls & Improving Balance Talk with Jackie Oliver, DPT, OCS

By Jackie Oliver, DPT
jackie@excelptmt.com

 

Preventing Falls & Improving Balance Talk

Presented by Jackie Oliver, DPT, OCS, on Zoom

Community Virtual Event – Free & open to the public

Zoom recording link: http://bit.ly/3qCZjwW

Learn how to assess & reduce your risk of falling and how to improve your balance with the latest evidence-based techniques.
 
  • Understand how physical therapy can reduce your risk of falling.
  • Learn how to improve your balance with at-home techniques and addressing modifiable risk factors.
  • Increase knowledge about what factors contribute to balance issues and how to intervene.
  • Recognize the health risks and injuries associated with older adult falls.
  • Falls can be prevented!
 
Jackie’s Preventing Falls & Improving Balance Talk Facebook Event Page 

 

Q&A transcript from the talk:
 

Q:  I fell yesterday walking and I have fallen a lot. All I can think of is, I am not picking up my feet enough? When I hit a crack or something I hit my toe and fall forward.   

A:  Sometimes that can be a strength thing, maybe your body is not strong enough, not that you can’t do it, but as you fatigue when you’re walking, you’re not lifting your feet as high because you are getting tired. So, your endurance might not be there in the lower extremity. It can be a multitude of factors…it could be your proprioception in the bottom of your feet aren’t picking up the cracks. A physical therapy evaluation can assess exactly what is causing your balance issues. As we get older, we tend to have balance issues that happen a little easier. We definitely don’t want you falling, especially outside on the hard concrete, that’s not a great place to be falling.  Definitely worth a mention to your doctor or physical therapist about what you are experiencing so a plan can be put into place to help address this issue for you.

 

Q:  I am someone who is dealing with peripheral neuropathy in my legs and feet, what do I do? Also, I am not able to lift my feet high enough when walking due to peripheral neuropathy. 

A:  So what you will want to do is uptrain like we talked about in that pie chart.  We talked about a third, a third, and a third for vision, vestibular and peripheral neuropathy.  The pie chart section that focuses on peripheral neuropathy is closing because you don’t have the sensation in your feet anymore. So you have to uptrain those other systems in order to compensate for the proprioception loss. Yes, it’s absolutely trainable.  Not being able to lift your feet high enough is a strength thing, with peripheral neuropathy, you’re not going to change the peripheral neuropathy, you’re going to uptrain those other systems. It’s like a muscle making those other systems stronger, so you aren’t worried about the peripheral neuropathy impact as much.    

 

Q:  Is there somewhere we can access the charts that you were talking about? 

A: The whole presentation will be loaded onto the Facebook page and the Excel website with the slides.  (coming soon)

 

Q:  What would you recommend as a call assist company for around your neck so if you fall you can get assistance? 

A:  With a little research online or by talking with family or friends, you can find one that will work with you. Recommendation given about Apple watch that asks if you have fallen and sends GPS tracking on where you are at if you don’t answer. 

 

Q:  Is there a booklet or something we can get with a detail view of different exercises we can build on for helping with resistance to falling? 

A:  A physical therapist can help determine a customized exercise program to help you with this. Also, tai chi, like yoga, is a great program to help with significant help on falling, some research showing up to 3 times a week has helped.  Talk to your physical therapist, because we can have different deficiencies because you may be deficient in your quads and hamstrings somebody else may be deficient in their glutes.  You may struggle with lifting your feet up and somebody else will struggle when they start doing head turns so getting a really specific exercise program is probably the best advice, so you’re not wasting your time so you’re not working on exercises you don’t need to work on.

 

Q:  Does Medicare cover balance training? 

A:  Yes, Medicare does cover balance training during a physical therapy appointment.   

Q:  Do you have suggestions on footwear?   

A:  Making sure you are in a footwear that you are comfortable walking in.  Something that isn’t bulky or has a high heel on it or has a big thick sole on it where you can get it caught on cracks in sidewalks.  Flip flops, sandals in the Summer time are going to be hard to justify because they can slip on feet and effect balance.  Specific footwear would be something to talk to your physical therapist to get headed in the right direction.   

 

Q:  Height of chair seat for a sit to stand desk? 

A:  There is a standard height, generally the measurement is dependent on height of the person using the desk. A physical therapist can help you determine the ideal  measurements best suited for your positioning needs.   

 

Q:  Balance with a new hearing aid?  

A:  Vestibular system is a big part of our balance system that contributes to balance and having a new hearing aid can throw of your balance because things are different for you.  

 

excel_faviconJackie Oliver, DPT, OCS completed her Doctorate in Physical Therapy at the University of Utah in Salt Lake City, Utah, one of the top Physical Therapy schools in the nation. She was fortunate enough to complete her clinical rotations and begin her physical therapy career within the University of Utah system, which is consistently ranked near the top in healthcare. Exposed to a wide variety of orthopedic conditions, Jackie is confident when assessing and treating a broad range of orthopedic impairments. Jackie is a certified dry needling provider with advanced training from Evidence in Motion and KinetaCore. Jackie achieved the Orthopedic Clinical Specialist advanced certification after extensive advanced training coursework and a stringent examination process from the American Physical Therapy Association.

Jackie has an intense passion for helping and educating others as well as preventative medicine. Because of her college sports background, Jackie loves working with athletes and has experience with biomechanical training and injury prevention in sports. 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.

Prior to completing her Doctorate in Physical Therapy, Jackie played basketball for Carroll College in Helena, Montana, while also obtaining a Bachelor of Arts degree in Health Science. Jackie was Academic All-American her last two years at Carroll.

 

 

Complimentary Student Athlete Injury Consultations for ALL Manhattan High School, Manhattan Christian High School and Three Forks H.S. Student Athletes

By Tiffany Coletta
tiffany@excelptmt.com

Free Student Athlete Injury Consultations

for ALL Manhattan High School, Manhattan Christian High School and Three Forks High School student athletes 

One-on-one session with Jackie Oliver, DPT, OCSMegan Kemp, DPT, ATC, CSCS or Lisa Palomaki, DPT in your local Excel Physical Therapy Manhattan, Montana clinic.  

Complimentary injury consultation sessions will help determine the best injury treatment options & plan to help return the injured student athlete back to the game healthy & strong.

Includes: 

  • Thorough history of athlete and review of injury  

  • Injury screen looking at strength, mobility, stability and impairments  

  • Education for athlete and parent/guardian on nature of symptoms and best course of treatment (PT, referral to MD, home rehabilitation program)

Call 406-284-4262 to schedule your complimentary student athlete injury consultation.

Learn more about us at https://bit.ly/3jDl0K0

#supportlocal  #communitysupport  #weloveathletes

 

 

Jackie Oliver, DPT, OCS

Megan Kemp, DPT, ATC, CSCS

Lisa Palomaki, DPT

 
 

Fall Events - Live from Uphill Pursuits' Instagram and Facebook Pages

By Tiffany Coletta
tiffany@excelptmt.com

Fall Events

Thursday (10/22) – 6pm

We’re super-excited to share an awesome presentation by Jason Lunden, DPT, SCS and AJ Sobrilsky, DPT, OCS broadcast from our friends & community partner’s Uphill Pursuits Instagram and Facebook pages. 

What Goes Up Must Come Down — Jason and AJ will be covering injuries in backcountry skiing & split boarding, how to minimize your risk of injury, and how to maximize your performance this winter.

Tune in this Thursday (10/22), 6pm as we broadcast live from Uphill Pursuit’s Instagram and Facebook pages – see you soon!

Bring your questions! Jason and AJ will be answering questions in the IGTV comments section under the broadcast.



 

Coming in November – Live on Zoom

 
 

In case you missed the live Uphill Pursuit collaborative broadcast – Simply click on the image above to watch Excel PT Climbing Lab’s awesome Transition to Climbing discussion. There’s a lot of very useful information to help you navigate the change of seasons as well as the change in loading and demand that shifting from outdoor to indoor climbing or rock to ice will introduce.

Excel Climbing Lab Doctors of Physical Therapy AJ Sobrilsky and Matt Heyliger offer insights on how to maximize training yields while minimizing injury risks.

 


The Excel Team extends support to you during this challenging season. Enduring together and drawing on resilience will help us get thru this COVID-19 time together. We are here for you in many ways –telehealth and in-clinic appointments, by phone or email–to help you anyway we can.
#enduringtogether
 

Outside Bozeman's "Push & Pull: Essential Ingredients for Running and Climbing" by AJ Sobrilsky, DPT, OCS

By Tiffany Coletta
tiffany@excelptmt.com

 

“Push & Pull…Essential ingredients for Running and Climbing” is AJ Sobrilsky’s latest article in the Outside Bozeman Summer issue.

Read the article here: https://bit.ly/2EUnvJ2

AJ is a physical therapist in Excel PT’s Bozeman clinic who uses specialized gait and the Excel PT Climbing Lab to help treat injury and provide skilled performance assessments.
#excelptmt
#excelclimbinglab
#excelrunningclinic
#montana
#bozeman
#physicaltherapy
#running
#climbing
#themountainathlete

excel_faviconAJ Sobrilsky, DPT, OCS is a Physical Therapist and Orthopedic Clinical Specialist in our Bozeman clinic.  AJ specializes in the rehabilitation and prevention of orthopedic sports related injuries with a specific interest in the management of those involving the upper and lower extremities. AJ received his Doctor of Physical Therapy Degree from Carroll University (Waukesha, WI). Following the completion of his DPT degree he participated in an Orthopedic Residency through Evidence in Motion at Bellin Health in Green Bay, WI providing him with advanced training in orthopedic manual therapy, clinical decision making, and patient centered treatment. Following completion of his residency AJ became an Orthopedic Clinical Specialist (OCS) through the American Physical Therapy Board Association and received advanced training in dry needling for spine and extremities.

AJ has been a lifelong athlete, competing in cross-country and track through college and then racing competitively post collegiately. As a result of his personal experiences and passions, AJ has focused his continued education and clinical development around the athletic individual with an emphasis in: running, skiing, and climbing related injuries. AJ has had the opportunity to provide care for an array of athletic populations including youth sports teams, high school and collegiate athletes, and those competing at professional and Olympic levels.

AJ’s treatment philosophy emphasizes a collaborative patient centered approach. Structured around the patient, supported by current best evidence, and coupled with specialized exercise/techniques, AJ hopes to educate the patient on their current issue and provide them with the best course of treatment to return to their previous/desired level of activity. 

When AJ isn’t working he is usually pursuing his next adventure: rock climbing, skiing, mountain biking, or running. 

 

Effective June 22, Phase 2 COVID-19 policies • Face Coverings Required • In-clinic & Telehealth appointments available

By Tiffany Coletta
tiffany@excelptmt.com

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Effective June 22, 2020, Phase 2  

 

Excel Physical Therapy’s Bozeman and Manhattan clinic COVID-19 Precautions for us all to stay safe and healthy. 

Thank you for your patience and accommodation.

 
  • All physical and massage therapy patients are asked to wear a face covering (mask, bandana, or scarf) when attending in-clinic appointments effective June 22.

This requirement does not apply to individuals who are unable to wear a mask or face covering due to a medical condition or to children under the age of 2. If you are hard of hearing, deaf and read lips, please notify us at check-in so we can accommodate you. We have transparent face masks arriving soon for our staff members to wear for you.

If you do not have a face covering upon arrival to the clinic, we will provide one for you. Please wear a face covering for your next in-clinic appointment so we can reserve supply for staff and patients in most need.

  • We are wearing face masks as staff members each day.
  • We are disinfecting patient, therapist and staff contact surfaces vigilantly on an hourly basis and after each patient interaction. We have a dedicated team member who is disinfecting the clinic and equipment constantly. 
  • We ask our screening questions when scheduling appointments on the phone and as soon as you arrive for your in-clinic appointment.
  • We are checking patient temperatures before each in-clinic appointment check in. 
  • We are checking staff temperatures before each shift.
  • We are not allowing any individuals to enter our clinic with ANY illness type symptoms or symptoms of COVID-19: fever, cough, difficulty breathing, flu-like symptoms like chills, fatigue.
  • We are having our patients and therapists wash their hands thoroughly before and after each visit. 
  • We have staggered patient appointments for social distancing practices. 
  • Visitors or guests are not allowed to attend in-clinic appointments with a patient (unless the patient is a minor, then only one parent/guardian please). 
  • If you have been diagnosed and recovered from COVID-19, please provide our front office team with your health provider’s clearance letter before attending your in-clinic appointment.
  • Please do not come to your in-clinic appointment until you have received health provider clearance if you have experienced virus exposure in the following ways (we are happy to do a video telehealth appointment in the meantime):
    • Diagnosed with COVID-19 that has not been classified as “recovered”
    • Close contact with an individual confirmed to have COVID-19 by lab testing or with a presumptive diagnosis of COVID-19.
    • Living in a house with anyone having symptoms consistent with COVID-19
Please let us know if you have any concerns or questions as we all proceed together through Governor Bullock’s phased reopening of Montana. Your feedback and suggestions are welcome and appreciated. Please direct inquiries and comments to info@excelptmt.com

Running Skills: A Talent Or Ability That Comes From Training And Practice - By AJ Sobrilsky & Jason Lunden 

By AJ Sobrilsky
aj@excelptmt.com

Who’s ever picked up a golf club and tried to knock it stiff from 130 yards out? That’s a tough feat to accomplish; a skill one might say. In fact, I’d argue that consistently hitting a golf ball where you want it to go and how you want it to look is one of the most difficult skills to develop.

That’s probably why most professional golfers, and high caliber athletes across the sports world, spend more time practicing and developing the skills of their specific sport than they do truly competing and playing. In fact, in David Epstein’s book “The Sports Gene,” there is a lot of discussion about practice, talent, and the genetics surrounding athletic performance. This is a highly recommend read or listen to if you’re looking for a good new book and it might help us all understand a little better our true capabilities and athletic realities (He also has a lot of podcasts as well as a Ted talk. Click here to listen

In the running world, there are those few individuals born with a unique physiological make up and a somewhat specific set of anatomical ingredients that lend them performance capabilities. But, that doesn’t mean there aren’t specific contributors to performance and skill development that can’t be modified, practiced, and fine-tuned to become your own best version of yourself. Sure the best runners are the ones spending a lot of time running and logging a lot of miles. Which leads a lot of us to come to the conclusion that in order to be our own best we need to run a lot. While increasing volume will improve your economy and times to some degree, it’s ultimately not the best solution. 

The old fallacy of more is better doesn’t hold true, at least not always. We can put time and effort into developing a bigger engine (cardio system, stronger muscles, more resilient mental game), but if we can’t control that engine and the forces it’s willing to produce, it’s useless. For instance, it’d be a bad idea to strap a jet engine onto a paper airplane or try to shoot a cannonball from a canoe. We need the right structure, skillset, and control to put these ingredients and tools to effective use. 

 

What do the best athletes in the world have in common (beyond the best genes)? They train, refine, retool, and practice the skills required for their specific activity. Unlike a lot of other sports, running doesn’t have a whole lot of diverse movements like soccer or climbing. This ultimately confines our exposure to different movements and limits our breadth of exposure and adaptability to forces outside the confines of the running gait. On the other side it also means we have a pretty consistent recipe or set of instructions for developing the best gait pattern and running movement strategy (all relatively dependent on our own unique set of factors). 

 

Jay Dicharry, a leading physical therapist and biomechanics researcher, delivers this message well when he says, “There are a lot of things that all runners of all abilities should be doing outside running to improve their running. If you want to run better, you need to move better”.  Essentially that the winner isn’t always the one who stacks up the most Strava KOM/QOM’s but rather the ones who have put time into developing and practicing the essential movement skills; allowing them to avoid injuries and ultimately providing optimal consistency in training.  

Running is essentially a fluid series of single leg jumps. The ability to produce enough force to drive your leg into the ground and propel yourself up and forward. To then coordinate the appropriate movements in the flight phase (while you’re going from step to step) in preparation for landing. And to then absorb 2-3 times your body’s weight through one leg, restoring that energy, and preparing to do it all over again in less than 0.4 seconds for each and every step throughout the duration of the run.  

 

So yes, running is a skill. What can you do to move better and become a more skilled runner? 

 

Before we dive into the specifics on the ingredients and tools required to address the skills of running, here are a few key essential components to practice during your next few runs:

 

  • Don’t Overstride: A lot of runners make the mistake of overstriding: putting their foot out too far in front of their center of mass. When a runner overstrides or reach, they increase their braking impulse and essentially slow themselves down with each strike. This is an inefficient way to run and significantly increases the amount of impact your body has to absorb. Therefore, overstriding can often lead to injury.  To avoid overstriding, avoid reaching your leg forward and try to strike just in front of your center of mass.
  • Cadence: Cadence is the number of steps you take while running. A slower cadence (or taking fewer steps per run) can be indicative of overstriding. Therefore, working on your cadence can be one way to improve your efficiency and reduce overstriding. Every runner will have a different cadence, but in general efficient runners run with a cadence between 176-188 steps/min. To work on your cadence, use a metronome app or setting on your watch and try and time your foot strikes to the beat of a metronome for 2-3 minutes. Then relax into your run for 2-3 minutes. Repeat 3-5x throughout your run.  Remember this is a drill to improve skill, so use it as a drill and don’t perform with every run or for your entire run.
  • Try not to bounce:  Much like overstriding, a bouncy gait is inefficient and can lead to injury. If you have a bouncy run, you are wasting energy pushing up rather than pushing forward. This also means your mass is landing from a higher height, increasing impact.  To avoid a bouncy gait, drive your leg back pushing you forward and not up. Centering your gaze on a landmark ahead of you and as you run try and keep the landmark as still as possible .
  • Drive from the hip and push from the ankle: The gluteus maximus is the biggest muscle in the human body. This is a big ingredient in the recipe to effectively and efficiently drive us forward with each step.  Sometimes runners rely too much on their calves and quads to propel them. This typically leads to overstriding and the bouncy gait described earlier. Therefore maximize your running efficiency by driving from the hip using the gluteus maximus; making sure not to arch at the lower back. Practice striding by driving/pushing from the glutes while stabilizing through your core to avoid your back from arching.

Here at Excel PT, Our running physical therapist team works with runners every day in our Running Clinic. It’s like a specialized clinic within a clinic. We’re here to help you develop these strategies to help improve your running skills and performance as well as help you prevent injury. 

 

 

excel_faviconAJ Sobrilsky, DPT, OCS is a Physical Therapist and Orthopedic Clinical Specialist in our Bozeman clinic.  AJ specializes in the rehabilitation and prevention of orthopedic sports related injuries with a specific interest in the management of those involving the upper and lower extremities. AJ has been a lifelong athlete, competing in cross-country and track through college and then racing competitively post collegiately. As a result of his personal experiences and passions, AJ has focused his continued education and clinical development around the athletic individual with an emphasis in: running, skiing, and climbing related injuries. AJ has had the opportunity to provide care for an array of athletic populations including youth sports teams, high school and collegiate athletes, and those competing at professional and Olympic levels.

 

excel-LOGO-X

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 in our Bozeman clinic. Jason is a Specialist in Sports Physical Therapy and 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 and co-owner of Excel Physical Therapy.

 

 

Our COVID-19 policies • In-clinic & Telehealth appointments available

By Tiffany Coletta
tiffany@excelptmt.com

91D8E06A-F316-4D16-B96E-9A3D45730782

 

 

However you need us, we are here.

Whether by in-clinic or telehealth appointment, phone or email, your Excel physical therapist is ready to help you. We realize there is a spectrum of how people feel during this moment. For those that feel comfortable to attend in-clinic appointments, we are seeing patients given certain restrictions (see below). And for those that who don’t feel comfortable to do that, we have telehealth appointments available for you from wherever you are. Excel Massage is open with the same precautions in place and you may schedule appointments in our Bozeman clinic here.

Our leadership has put consistent and specific safety precautions in place in our clinics for you and our staff. We will continue to implement safety precautions as best practices and guidelines emerge.

Whether you are in pain and want a non-medication, long-term solution, or an athlete who desires returning to your sport stronger and better equipped, Excel Physical Therapy’s highly trained practitioners and advanced therapy philosophies can help you. 

The value of team.
Our team specializes in specific body areas and treatment disciplines to provide you with the best care outcomes available in the Gallatin Valley. To do this, Excel Physical Therapy intentionally invests in nationally recognized advanced training and holds weekly sessions amongst our physical and massage therapy team members to exchange specialized knowledge. This collaboration allows us to utilize evidence-based progressive treatments to better reunite you with pain-free comfort, functionality, and performance. 

Next year, Excel Physical Therapy will be celebrating two decades serving the Gallatin Valley. Over the years, we’ve achieved and fine tuned an expansive and innovative expertise that allows us to lead patients in a consistent, dedicated and trusted manner.

To our community, thank you for being the best part of Excel Physical Therapy. However you need us, we are here for you.

 
 
 

Our Bozeman and Manhattan clinic COVID-19 Precautions for us all to stay safe and healthy.

Thank you for your patience and accommodation with these polices.

We are:

  • Suggesting all patients wear a face covering when attending in-clinic appointments. Here’s some CDC mask handling tips.
  • Wearing face coverings as staff members each day.
  • Disinfecting patient, therapist and staff contact surfaces vigilantly on an hourly basis and after each patient interaction.
  • Screening patients regarding any illness symptoms and travel. We ask our screening questions when scheduling appointments on the phone and as soon as you arrive for your in-clinic appointment.
  • Asking anyone who’s returned to Gallatin Valley after travel outside Montana to self-isolate for 14 days before attending in-clinic appointments.
  • Checking patient temperatures before each in-clinic appointment at check in. 
  • Checking staff temperatures before each shift.
  • Not allowing any individuals to enter our clinic with ANY illness type symptoms or symptoms of COVID-19. 
  • Having our patients and therapists wash their hands thoroughly before and after each visit. 
  • Following social distancing guidelines in the clinic.
  • Not allowing visitors to attend in-clinic appointments with each patient (unless the patient is a minor, then only one parent/guardian please). 
Please let us know if you have any concerns or questions as we all proceed together through Governor Bullock’s phased reopening of Montana. Your feedback and suggestions are welcome and appreciated. Please direct your inquiries and comments to info@excelptmt.com
 
✶ In-Clinic Appointments available at our Bozeman and Manhattan clinics.
✶ Telehealth Appointments available to you from where ever you are with all of our Physical Therapy providers
✶ Massage Appointments available at our Bozeman clinic with James Beaudry, LMT. Brittnee Harper, LMT is back in the clinic July 1st, 2020.
Schedule Massage Online 》
 

Subscribe to our new Youtube channel. Help us share our channel with your tribe ➛

See what our team has been doing to help near and far during quarantine. Climbing and running injury prevention videos are available from our speciality pt teams.

We’re also sharing our running injury prevention talks done in our Bozeman clinic that would have been held at Uphill Pursuits during recent quarantine months. We’ll be sharing more episodes soon. We also hear a Bike Fitting video is rolling soon 🙂
#supportlocal  #excelptmt

 
Tour the latest Blog articles written by Bozeman clinic’s AJ Sobrilsky, DPT, OCS and Manhattan clinic’s Megan Kemp, DPT, ATC, CSCS:
AJ Sobrilsky, DPT, OCS
Megan Kemp, DPT, ATC, CSCS
Treating Chronic Pain by Megan Kemp, DPT, ATC, CSCS
The Balancing Act of Avoiding Running Injuries by AJ Sobrilsky, DPT, OCS
The Answer Is Load, What’s The Question? by AJ Sobrilsky, DPT, OCS
click for more articles on more topics
 

★★★★★
Recent Google Feedback:
“I have been working with AJ Sobrilsky for several months prehabbing before knee surgery. He and the entire support staff at Excel are kind, friendly and easy to work with, and I have been beyond pleased with my progress. AJ does a great job of balancing proper care with the right amount of pushing my limits so that pre-surgery I was back on (easy) hiking trails and road biking at normal spring levels.

Excel has been great at keeping everyone safe during this pandemic and I’ve never felt unsafe or worried about cross-contamination in their facility as I see staff constantly sanitizing all surfaces and equipment. Highly recommend AJ and the Excel team.”
–A.F., Bozeman patient

 
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The Answer Is Load, What’s The Question? by AJ Sobrilsky, DPT, OCS

By AJ Sobrilsky
aj@excelptmt.com

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What unique times and circumstances we find ourselves in as climbers. The climbing gyms are closed, all the home gym products are sold out, and as a community we’ve put others best interest ahead of our passion and stayed local respecting the pleas to avoid traveling to popular climbing destinations. So it seems like no better time to take care of some essential preparation in our personal climbing dojos. What better time to begin or continue training, hone and establish an armor of strength, or finally address that “insert nagging climbing related ache here” you’ve had going on for months now. Whether you’re using a hangboard to strengthen those fingers, campusing to develop some power, or taking to the kettlebells and theraband to recover it all boils down to loading. 

 

Loading simply is stress applied to a tissue or structure (muscle, tendon, bone) that results in some type of adaptation (stronger, stiffer, smarter). Load can be a good and a bad thing. Load in excess goes beyond the tissues capacity to remodel and adapt and could potentially result in a reactive response or injury. In fact there really is no injury; acute, chronic, or traumatic that simply doesn’t boil down to loading beyond capacity. But uniquely enough in this situation the problem or cause is also the answer and solution.

 

There are many types, strategies, and forms of loading depending on our desired response: rehabilitative loading, adaptive loading, stimulus loading, and reactive loading. While for the purpose of this specific post we’ll solely reference load as a physical stimulus we must remember that load stimuli is also psychological (more on that in a future post). So the answer to both improving your climbing performance, taking care of that nagging injury, and building up that armor of injury resilience is loading. Rest is not the best, and yes if you don’t use it you will lose it (however there is a caveat and exception for acute traumatic injuries: ACL repairs, grade III pulley ruptures, or Rotator cuff and SLAP repairs where we need to respect a typical tissue healing timeline). But if you’re still convinced rest is what you need here’s a simple guide to help you with that. https://www.climbing.com/skills/unsent-how-to-be-injured/

 

Loading isn’t always an exact science. A lot of factors and contingencies are at play when it comes to determining the amount, type, duration, and frequency of loading. For instance, your current training phase, training age, training history, injury history, and long term goals will influence how we’d load differently from one climber to another. Whether you’re 2-3wks into an acute injury or 3-4months of consistent aggravating complaints would also impact the loading program.

 

Hopefully, this post provided some insight to continue, progress, or adjust your current training. Or maybe it was just a quick break between burns on your home board that you’ve finally had time to finish (or start building). So with all that here is a final few tips, key concepts, and strategies to consider when loading:

 

  • Gradually and slowly progress load – Probably the most important one! 
  • Variables to consider modifying with loading: volume, velocity, duration, loading positions (different grips) 
  • Vary the surface or position you’re loading in: tension block, flash board, hangboard, single rungs, different board systems or walls.  
  • Respect the recovery required to adapt from a specific training session and/or training cycle.
  • Develop climbing specific skills: climbing is a unique sport with an ever changing set of parameters required to complete and thus ever changing and adapting set of skills required to be successful. It’s one thing to be strong but it’s another to know how to harness that strength to achieve desired goals. 

Here at Excel Physical Therapy, we are ourselves climbers and patients as well as climbing research, training, and rehabilitation specialists. So we get it.  We understand what you’re going through, and we can help you figure out how to take the steps towards those climbing goals. We’d love to have you in person in the Excel Climbing Lab for a climbing evaluation, evaluate and establish a plan for that nagging injury, or consult for injury/performance questions via an in-clinic or telehealth appointment. We’re here for you and we’d love to keep providing more and more information on all things climbing so please let us know if there is anything specific you’d like to hear and learn about. 

 

excel_faviconAJ Sobrilsky, DPT, OCS is a Physical Therapist and Orthopedic Clinical Specialist in our Bozeman clinic.  AJ specializes in the rehabilitation and prevention of orthopedic sports related injuries with a specific interest in the management of those involving the upper and lower extremities. AJ received his Doctor of Physical Therapy Degree from Carroll University (Waukesha, WI). Following the completion of his DPT degree he participated in an Orthopedic Residency through Evidence in Motion at Bellin Health in Green Bay, WI providing him with advanced training in orthopedic manual therapy, clinical decision making, and patient centered treatment. Following completion of his residency AJ became an Orthopedic Clinical Specialist (OCS) through the American Physical Therapy Board Association and received advanced training in dry needling for spine and extremities.

AJ has been a lifelong athlete, competing in cross-country and track through college and then racing competitively post collegiately. As a result of his personal experiences and passions, AJ has focused his continued education and clinical development around the athletic individual with an emphasis in: running, skiing, and climbing related injuries. AJ has had the opportunity to provide care for an array of athletic populations including youth sports teams, high school and collegiate athletes, and those competing at professional and Olympic levels.

AJ’s treatment philosophy emphasizes a collaborative patient centered approach. Structured around the patient, supported by current best evidence, and coupled with specialized exercise/techniques, AJ hopes to educate the patient on their current issue and provide them with the best course of treatment to return to their previous/desired level of activity. 

When AJ isn’t working he is usually pursuing his next adventure: rock climbing, skiing, mountain biking, or running. 

 

The Balancing Act of Avoiding Running Injuries by AJ Sobrilsky, DPT, OCS

By AJ Sobrilsky
aj@excelptmt.com

While it’s become a common flex in the running community to log lots of mileage, vertical gain, or cherry picking all the local strava segments (I mean if you don’t post about it, did you actually run it?) it’s important to make sure we’re doing so responsibly.

Lifts are closed, the days growing longer and the weather improving, not to mention, most of us have more time to recreate on our hands due to a global pandemic. We at Excel PT, like most of the local community, have taken to putting in some time on the pavement and trails. However, despite all this new found time and psych, it’s essential we harness our urges and make sure we don’t push beyond our capacity landing ourselves in a needed/forced time off of running because of an injury. We’ll discuss some of that balance required in order to be smart about our training, and make sure we’re all ready for when we can once again gather as a community at a start line or beer tent (hopefully both) after a local race.  

We’re all guilty of it. That common belief that running more will make us faster. While there is truth to some degree in that statement, there does become a point of diminishing return and a balance between running more and running better is required. Unfortunately in the even that we decide to just run more, and more, we’ll eventually exceed our tissues capacity to tolerate that amount of running. Capacity in this situation is reflected in our bodies ability to tolerate loading, more specifically: how much running can we perform before we have an injury?

Let’s start by pointing out that our bodies are incredibly smart and adaptable. Let’s also be sure that we all understand that running is a skill, and skills require practice. Practicing skills with poor form and technique will only reinforce those poor patterns. In the case of running, sometimes our lack of skill leads to a pattern that overloads a tissue. It is true that lack of skill can be adapted to, but at some point of the loading process, we exceed the capacity for adaptation and a painful reaction occurs = injury.  

The trick in this whole equation is finding the balance between loading and our capacity. So what all goes into determining the amount of load: volume, duration, frequency, intensity, rate of change, lifestyle habits, etc.,? What determines our own unique individual levels of capacity: strength, control, mobility, skill performance, previous injury, training history, sleep, life stress, diet, etc.,? As you can see, there is A LOT to account for and when we stack up lots of load, we have a potential to exceed our own bodies physical limits of capacity: injuring tissues.  

So how do we mitigate overloading these tissues and work towards preventing running injuries? We work to improve our own modifiable individual capacity factors while strategically and gradually loading. Here are some of our top tips to make sure you’re appropriately managing your running: 

  • Keep a log: this is a great place to write down distance, intensity/effort, vertical changes, who you went with, what the weather was like, and even if you started to feel a little pain or ache. This is also a great outlet for a runner to reflect and be mindful about their training. We are big on mindfulness here as a team.
  • Vary your running pace/intensity: adding in tempo runs, intervals, or hill workouts is a great way to slightly add variance to the loading/demand on tissues. This will make sure their stress isn’t always constant and also make sure the tissues are ready for the demands of upcoming runs and races. 
  • Vary your terrain and routes: running the same loop everyday might be your thing but I know for me personally and my body, that if I’m providing it some different stimulus not only am I mentally relieved but again my body is prepped for variability in the future. If you’re primarily trail running, throw a few road miles in. If you’re a road running, throw a few single track miles in.  
  • Listen to your body: this is probably the most important one. Making sure your body gets the sleep, nutrients, and care it requires is essential to long term running and mental health. I continually need to remind patients (and myself a lot of times) that the only time we can actually adapt and recover is when we are resting. So to go out and chase the Strava records, while being at max effort everyday, you will only be left in a hole/deficit. You will be unable to tolerate the day to day stresses and your body won’t function at its highest level. 
  • Gradually load: strategically increase volume. Common rule of thumb is no more than 10%increase in volume from the week before and allowing for a “down” week following 2-3 weeks of increased volume. If you don’t feel you’re capable or able to do this there are a lot of great running coaches and physical therapists out there who can help build, guide, and modify for your individual needs. 
  • Improve your skill set: “Sharpen your sword”. There are a lot of modifiable factors that can be addressed to improve your capacity – stay tuned for upcoming posts with specifics on these! 

If you were looking for the answer to the holy grail question of how to avoid getting a running related injury here it is: don’t run. But since you made it this far in this article, I doubt that’s an option for your nor do we at Excel PT want that to be the answer to your questions.

Unfortunately this singular article probably won’t answer all the questions about running injuries, form, and training that you have. At Excel Physical Therapy there are many physical therapists who are professionally and personally invested in understanding, managing, and treating running related injuries and we are here to help you with any question or concern. Please feel free to reach out for a running evaluation in our running lab, or discuss a running related complaint via an in-clinic or telehealth appointment. 

Stay tuned for more blog posts to come. Leave a comment and let us know what topics you’d like to learn more about!

 

excel_faviconAJ Sobrilsky, DPT, OCS is a Physical Therapist and Orthopedic Clinical Specialist in our Bozeman clinic.  AJ specializes in the rehabilitation and prevention of orthopedic sports related injuries with a specific interest in the management of those involving the upper and lower extremities. AJ received his Doctor of Physical Therapy Degree from Carroll University (Waukesha, WI). Following the completion of his DPT degree he participated in an Orthopedic Residency through Evidence in Motion at Bellin Health in Green Bay, WI providing him with advanced training in orthopedic manual therapy, clinical decision making, and patient centered treatment. Following completion of his residency AJ became an Orthopedic Clinical Specialist (OCS) through the American Physical Therapy Board Association and received advanced training in dry needling for spine and extremities.

AJ has been a lifelong athlete, competing in cross-country and track through college and then racing competitively post collegiately. As a result of his personal experiences and passions, AJ has focused his continued education and clinical development around the athletic individual with an emphasis in: running, skiing, and climbing related injuries. AJ has had the opportunity to provide care for an array of athletic populations including youth sports teams, high school and collegiate athletes, and those competing at professional and Olympic levels.

AJ’s treatment philosophy emphasizes a collaborative patient centered approach. Structured around the patient, supported by current best evidence, and coupled with specialized exercise/techniques, AJ hopes to educate the patient on their current issue and provide them with the best course of treatment to return to their previous/desired level of activity. 

When AJ isn’t working he is usually pursuing his next adventure: rock climbing, skiing, mountain biking, or running. 

 

"I hated to 'graduate' today! Jackie was so encouraging - she worked me hard but what great results! Thank you so much!"--C.L. Manhattan Patient

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