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The Runner’s Arch Nemesis by Megan Kemp, DPT, ATC, CSCS

By Megan Kemp
megank@excelptmt.com

Summer is finally here and with it comes all of the fun outdoor activities we love doing. But what if your best laid intentions to get outside are derailed with sore feet? Did you know that physical therapy is an effective treatment option for foot pain? 

Foot pain is generally multi-faceted. There is rarely one simple cause for the pain, nor is there often a quick fix. However, there are often some common themes that put you at a higher risk for pain. One common cause is reduced mobility at one of the multiple joints of the foot/ankle complex. Decreased mobility at one joint can lead to excessive mobility at other joints throughout the foot. It is common for hyper- or hypomobility to be a pain generator for the foot. Another common cause is decreased strength or motor control of important stabilizing muscles throughout the lower extremity. This can change the way your foot absorbs shock or pushes off, thus putting excess stress on parts of the foot that weren’t designed to take that excess stress. Altered biomechanics of the lower extremity throughout the gait cycle are another common cause of pain. 

Physical therapists are highly trained experts in recognizing faulty biomechanics throughout the body. By recognizing where the faulty mechanics lie, you can then effectively treat the root cause of your pain rather than simply the symptoms. This is helpful in not only reducing your pain, but giving you the tools to treat it in the future should your pain creep back into your life. At Excel Physical Therapy, we also specialize in affordable, semi-custom orthotics that are specially designed to your unique foot structure. Orthotics can help place your foot in it’s optimal biomechanical position to reduce stress and optimize function.

If you have foot pain, the physical therapists at Excel Physical Therapy can help! We provide a specialized approach to physical therapy that provides the most effective manual, orthopedic, and sports therapy treatments, allowing our patients to return to their highest level of function as quickly as possible. We have proudly been serving the Gallatin Valley in both Bozeman and Manhattan since 2001. Call us today to schedule an appointment!

 

excel-LOGO-XMegan Kemp, DPT, ATC, CSCS, a Gallatin Valley native and graduate of Manhattan Christian High School, 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 Kemp practices in our Manhattan office.


Vestibular Treatment Now Available at Excel Physical Therapy Bozeman

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

One of the great things about being a physical therapist at Excel Physical Therapy is the commitment that all of our clinicians have to life long education. This philosophy of commitment to growing and learning benefits us as clinicians, you as patients, and the Bozeman community as a whole. It is one of the things that allow Excel PT to impact our community in such a positive way and offer the best care we possibly can.  

As a spine specialist trained in manual orthopedic therapy, I treat my fair share of cervical spines. It is one of my favorite things to treat. It is interesting and complex.  Manual therapy is hugely beneficial for a variety of cervical diagnosis. These diagnosis can include cervical stenosis, cervical discs, cervical radiculopathy, upper cervical dysfunction, headaches and even dizziness related to general cervical dysfunction better known as cervicogenic dizziness. One of the things I enjoy most is resolving dizziness related to cervical dysfunction. Anyone who has dealt with a bout of dizziness knows how uncomfortable and debilitating it can be. It is so helpful to have this skill as a physical therapist so I decided to start thinking about how I could start addressing dizziness from a variety of origins not just cervical dysfunction.  

This interest of mine as well as the need I saw in the community, resulted in me flying to Atlanta and enthusiastically participating in the Emory University Vestibular Rehabilitation Competency Based Course. This course is the gold standard in vestibular continuing education. It is an intense, evidence-based course designed for physical therapists, occupational therapists and MD’s with experience treating patients with vestibular deficits.

Participants who successfully achieve the Emory University Certified Vestibular Specialist designation successfully complete a practical exam, a written exam and a video exam demonstrating assessment skills including an oculomotor exam, balance assessment, gait assessment, fall risk assessment and other functional assessments. Participants also demonstrate appropriate treatment procedures for benign paroxysmal positional vertigo (BPPV) affecting posterior, anterior and horizontal canals for both cupulolithiasis and canalithiasis, for unilateral and bilateral peripheral vestibular disorders, and for central vestibular disorders including traumatic brain injury, concussion and stroke.  

What does all of this mean? If you have dizziness, vertigo, balance problems or a variety of other issues resulting in this type of discomfort, you can come to Excel Physical Therapy, located at 19th and College streets in Bozeman, for relief and treatment by a highly trained physical therapist. We have a customized “vestibular room” with all the necessary equipment for accurate diagnosis and treatment including infrared goggles. I look forward to working with our clients who will benefit tremendously from this specialized physical therapy remedy that has very successful outcomes.

 

excel-LOGO-XBobby 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. Bobby achieved an Emory University Certified Vestibular Specialist designation due to advanced training and examination from the Emory University Vestibular Rehabilitation Competency-Based Course. 

 

-Bobby 

Vestibular Specialist added to Bobby Bemis, DPT, COMT, DIP. MT, FAAOMPT's Treatment Focus

By Tiffany Coletta
tiffany@excelptmt.com

Bobby Bemis, DPT, COMT, DIP. MT, FAAOMPT

Excel Physical Therapy is very pleased to announce that Bobby Bemis, DPT, COMT, DIP.MT, FAAOMPT has achieved an Emory University Certified Vestibular Specialist: 2019 designation due to advanced training and examination.

The Emory University Vestibular Rehabilitation Competency-Based Course is the gold standard in vestibular continuing education. The course is an intense, evidence-based course designed for physical therapists, occupational therapists and MDs with experience treating patients with vestibular deficits. Participants who successfully complete this course will complete a practical exam, a written exam and a video exam demonstrating assessment skills including an oculomotor exam, balance assessment, gait assessment, fall risk assessment and other functional assessments. Participants also demonstrate appropriate treatment procedures for Benign paroxysmal positional vertigo (BPPV) affecting posterior, anterior and horizontal canals for both cupulolithiasis and canalithiasis, for unilateral and bilateral peripheral vestibular disorders, and for central vestibular disorders including traumatic brain injury, concussion and stroke.

“Benign paroxysmal positional vertigo (BPPV) is one of the most common causes of vertigo — the sudden sensation that you’re spinning or that the inside of your head is spinning. Benign paroxysmal positional vertigo causes brief episodes of mild to intense dizziness.”–Mayo Clinic

Bobby is treating vestibular clients in the Excel PT Bozeman office, located at 19th and College streets, who are experiencing dizziness, vertigo, and balance issues. Specific treatment interests include Meniere’s disease, benign paroxysmal positional vertigo (BPPV), vestibular neuritis, ototoxicity, nystagmus, labyrinthitis, vestibular hypofunction, acoustic neuroma, concussion, stroke, and vestibular migraines.

Learn more about Bobby’s advanced training and certifications here.

 

Oliver and Schumacher add OCS to their Physical Therapy Titles...Team Excel is Celebrating!

By Tiffany Coletta
tiffany@excelptmt.com

 

Jackie Oliver, DPT, OCS

Matt Schumacher, DPT, OCS, MTC, CAFS, CSCS

Jackie Oliver, DPT, OCS and Matt Schumacher, DPT, OCS, MTC, CAFS, CSCS recently passed the rigorous Orthopaedic Clinical Specialist (OCS) examination in March 2019. Orthopaedics is the specialty dealing with the musculoskeletal system: bones, muscles, cartilage, tendons, ligaments and joints. This examination covered everything pertaining to orthopaedic physical therapy from head to toe. In order to sit for the exam one must have completed at least 2,000 hours of direct orthopaedic patient care within the last 10 years or have completed a post-professional residency in the field or orthopaedics.  

The Orthopedics Clinical Specialist (OCS) advanced certification is coordinated by The American Board of Physical Therapy Specialists (ABPTS). The organization oversees a specialist certification process from the nine different specialties one can attain within the realm of physical therapy.  The ABPTS mission is “to advance the profession of physical therapy by establishing, maintaining, and promoting standards of excellence for clinical specialization, and by recognizing the advanced knowledge, skills and experience by physical therapist practitioners through specialist credentialing.”

Under the ABPTS advanced certification programs, we at Excel Physical Therapy have 1 Board-Certified Sports Clinical Specialist (Jason Lunden) and 3 Board-Certified Orthopaedic Clinical Specialists (Megan Peach, Matt Schumacher, and Jackie Oliver). As of 2018, there are only 86 Board-Certified Orthopaedic Clinical Specialists in the State of Montana, making this designation a well respected and prestigious title.  Excel Physical Therapy’s team values incorporate investing in and encouraging advanced training and certifications for all of our physical therapy providers to help ensure excellent care and outcomes for our clients. 

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.

 

Running Experts Forum 2019 • April 17th @ 6:30pm

By Tiffany Coletta
tiffany@excelptmt.com

Community Education Series – free and open to all 

 

Running Experts Forum

 

Join us for an interactive, moderated panel discussion with Bozeman’s running experts about ALL things running. Door Prizes!

 

Wednesday, April, 17, 2019

6:30-7:30pm

Bozeman Public Library Community Room

Follow this event on Facebook!

 

Panel discussion topics to include: 

Injury Prevention • Running mechanics • Training tips & techniques • Shoe selection • Foot strike pattern • Staying motivated • Answering your questions! 

 

Panel Guests:

  • Our first panel guest is a Montana State University distance coach! Hear a coach’s perspective on training, technique, and injury prevention.

  • James Becker, PhD is an assistant professor at MSU in the Health and Human Development program. His research interests include biomechanical aspects of human performance and biomechanical factors contributing to orthopedic injuries and he has published numerous articles on running mechanics and running related injuries.  

  • Erika Rauk is a registered dietician and also has a masters degree in exercise physiology and sports nutrition. 

  • Nikki Kimball is an elite ultramarathon runner with numerous national titles, physical therapist and a longstanding member of the “Runners World” magazine advisory board. 

  • Jason Lunden, Sports Clinical Specialist, Physical Therapist and co-owner of Excel Physical Therapy 

  • Moderated by Megan Peach, Physical Therapist & Orthopedic Clinical Specialist at Excel Physical Therapy

Do you have a running question you’d like the panel to answer at the forum? Post your question on our Facebook event page. While you’re there, check out the Relax & Run Giveaway contest on our Facebook and Instagram pages. Post a question, like/follow us and enter to win a free 60-minute Excel Massage!

Seating is limited to 100 attendees. For more information, contact Megan Peach, DPT, OCS, CSCS at 406.556.0562 or megan@excelptmt.com.

  

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.

Your Chronic Low Back Pain Could Be Instability of the Spine Lurking in the Shadows

By David Coletta, MPT, CMPT
david@excelptmt.com

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While 80% of all US citizens will experience some level of low back pain during their lives, 10.2% (2006 US Survey) of all adults in this country have suffered from chronic low back pain that limits activity for an extended period of time.  As a physical therapist that specializes in treating the spine, I often have chronic low back pain patients that struggle to understand why their condition exists.  Many clients arrive for an evaluation after years with severe bouts of low back pain that comes and goes with minimal cause or explanation.  Trips to the doctor for medication, days missed from work, and visits to various types of practitioners are common with this diagnosis. My experience has found that some of these chronic low back pain patients have spinal instability as the source of their condition. 

Spinal instability or excessive vertebral segmental motion is a possible cause of chronic low back pain.  General wear and tear, previous injuries, and congenital abnormality of the vertebrae can be factors that lead towards instability.  Looking at the spine with the muscles removed, there is a beautiful structure that is present which allows for movement, but also provides stability from one spinal segment in relation to its neighbor (above or below).  The discs, ligaments, and vertebrae themselves provide this passive stability.  Compromise to these structures can lead to instability or an excessive amount of movement.  The muscles of core and deep spine provide protection and smooth movement between the vertebrae and the low back in general, which is termed dynamic stability. When passive stability is lacking, dynamic stability is in greater need.  However, dynamic muscular stability of this level is often lacking in spinal instability patients.  With these individuals, acute low back pain bouts arise when an activity, such as shoveling snow or even bending over to pick up a pencil from the ground, overloads the available passive and dynamic stability.

Perhaps the most common form of low back instability is an anterior spondylolisthesis or a slippage forward of a lumbar vertebra in relation to the vertebra below it.  This diagnosis can be picked up through a detailed and specific physical therapy evaluation and then confirmed with a specialized x-ray of the lumbar spine.  A spondylolisthesis has various grades, depending on the degree of slippage measured on the image. A mild or even moderate spondylolisthesis is best treated with specific core stabilization exercises and teaching the patient how to safely lift, given this diagnosis.  Higher grades of spondylolisthesis may require surgical spinal fusion to stabilize the segments. Many patients go years or decades without understanding the true source of their chronic low back pain.  In some cases, instability or spondylolisthesis is the culprit lurking in the shadows.

 

As the founding owner of Excel Physical Therapy, David Coletta, MPT, CMPT strives for our clinics to deliver unprecedented excellence with patient care in the Gallatin Valley. David established Excel PT in 2001 on the principles of specialization, advanced education and customer service. David specializes in the treatment of back and neck pain, spinal issues, whiplash, headaches, TMJ/jaw pain, and postural dysfunctions. 

A considerable amount of David’s advanced training occurred through the North American Institute of Orthopedic Manual Therapy (NAIOMT). He has completed advanced certification in manual therapy (CMPT) with NAIOMT, and he has received advanced training in dry needling techniques for the spine and extremities. David is a Certified Clinical BikeFit Pro Fitter.

"Have Bobby fish more … Take care of this guy, he did me a world of good!" -- D.R., Bozeman Client

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