6:30pm @ Spire Climbing in Bozeman, Montana – sign up to attend at spireclimbing.com
May 4 – Elbow Injury Talk with Dr. Lisa Palomaki, DPT
Lisa’s talk is full already on the Spire Climbing website – Watch on @excelptmt’s IGTV page to see her talk streamed live!
June 1 – Injury Screening with Dr. Todd Bushman, DPT, CSCS
July 6 -Wrist Injury Talk with Dr. Todd Bushman, DPT, CSCS
Aug 3-Strength Assessments with Dr. AJ Sobrilsky, DPT, OCS
Here’s what happens for each session type:
Injury Talk – Want to learn more about common climbing injuries & actively manage the situation? Don’t miss out on these quarterly presentations from an Excel Physical Therapy Climbing Lab PT. We’ll tackle some of the more common climbing injuries while discussing rehab, injury mitigation, training considerations, & the most important question of all: “Can I keep climbing?”
Injury Screening – Free 15-minute injury consultations with a doctor of physical therapy from Excel Physical Therapy.
Strength Assessment – Free assessment of specific climbing strength performance metrics: max finger strength, finger contact strength, critical force, & finger strength endurance. See where you measure up, areas that might need attention, & assess your training. Stop guessing & start assessing.
Follow us on our @excelptmt IG page for the latest updates and event info.
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.
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
Please enjoy Consilience with John Onate’sPart 2 podcast with Nikki Kimball: Maintaining A Love For Running through Injury and Adversity.
Nikki uses a combination of humor, friendship, medical advice and compassion to overcome injury, aging and now the pandemic. As John Onate says, there is a lot to learn from Nikki Kimball. The Excel PT Team completely agrees!
Nikki Kimball is one of the most competitive and successful Ultra-Endurance Athletes in the history of Road and Mountain-Trail-Ultramarathon racing:
2nd place, Hardrock 100, 2018
2nd place, HURT 100m, 2017
2nd place, Big Horn 100m, 2016
1st place, Marathon Des Sables, 2014
Western States 100 Champion 2004, 2006, 2007
Ultra Trail du Mont Blanc 108 Mile,Champion, 2007
Member of United States 100K Team 2001-2006; 8th overall and 1st American at World Cup 2003, Tainan, Taiwan; 7th at World Cup 2005; scoring member of gold medal 100K team at World Cup 2005
We are honoring National Suicide Prevention Week by sharing this podcast episode from Consilience with John Onate who features Nikki Kimball from the Excel PT Bozeman running clinic team. Nikki is one of the most competitive and successful Ultra-Endurance athletes in the history of Road and Mountain-Trail-Ultramarathon racing (and one of the kindest and smartest people we know).
In this episode from the keynote presentation to the Central California Psychiatric Society Annual Meeting in 2016, Nikki discusses how depression, medicine, doctors, running and physical therapy have impacted her life, career and advocacy mission. Mature themes discussed.
As John Onate says, We all can learn and be inspired by Nikki Kimball. We completely agree!
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.
AJ 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.
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!
AJ 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.
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.
Megan 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.
"I want to add my name to the long list of people who recommend EXCEL Physical Therapy. I was active in sports for 14 years and operated a building maintenance business for 30 years. I have developed a number of physical health problems over the years. David worked with me one-on-one to successfully treat a serious nerve problem which limited my ability to drive. David and his staff are among the finest therapists I have had the pleasure of working with. I highly recommend them to anyone who has physical health challenges and need the best care possible." --J.D., Bozeman Patient
credit: Consilience_podcast Instagram
