406.556.0562 Bozeman
406.284.4262 Manhattan
info@excelptmt.com
Effective June 22, Phase 2 COVID-19 policies • Face Coverings Required • In-clinic & Telehealth appointments available
|
|
Spend Time Hanging and Start The Season Stronger - by Matt Heyliger, Excel PT Climbing LabWith the current state of things, many climbers who have not previously set up a hang board and/or training area at home are tackling these tools up at home and getting their hang on. Many others who had a routine of hanging at home prior to COVID-19 are back at it in full force. This is a great time to develop a more systematic approach to training.
Through this experience, trial and error has revealed some key points to consider when hanging at home. First and most important, how do you pull off a proper warm up without a climbing wall? I strongly believe your home warm up needs to be systematic to properly warm up while gauging how you’re feeling on a given day. It’s vital here to let go of your expectations (and ego) and to honestly assess your recovery from your previous bout of training. Sometimes you realize you’re feeling a lot better than you thought as you progress through your warm up. And sometimes you feel heavy and weak when you expected to feel great. Listen to your body and respect the process.
The first 20-25 minutes of your session should consist of a progression with light loading on larger holds trending toward the holds the given workout will emphasize. If you have the space and ingenuity to safely anchor a pulley set to offload some of your body weight (plenty of DIY info out there on this) this can be really helpful for warming up. For many this will enable you to train safely as your connective tissue in you fingers, hands and elbows adapt to this form of loading. You can also unweight your feet to progressively increase load keeping a little body weight on the floor, perhaps progressing to both or single tippy toe position.
Start with a set of 2-3 minutes with 10 seconds on, 10 seconds off hold times on a large 4-finger pocket edge or a jug on the top of the board. This should feel fairly easy; you should feel warmth in the forearms and hands but not enough strain to develop a pump. Take an equivalent timed rest period, 2-3 minutes. During this time you should perform active warm up drills for the upper body, perhaps a few push- ups or pull-ups, anything to get the blood flowing in the shoulders and arms. Repeat another warm up set, now 3 minutes in duration, still 10 seconds on, 10 seconds off but increasing the load or perhaps starting to decrease the hold size. Change one variable at a time and see how things feel. At the end of this set, you really want to feel the forearms working, working up to 60% effort to complete the set. Rest an additional 3-4 minute while performing continued dynamic upper extremity warm up drills.
For the last warm up set, I would recommend trending your on/off time to match the workout you are doing that day. A very common work out called repeaters involves 7 seconds on followed by a 3 second rest per rep. This set should be exclusively on the holds you are training on that day. I like to extend the rest time this set using 7 seconds on and 13 seconds off for the entire set to accommodate increased load. I find this fends off burning key energy needed for a successful workout while loading closer to the time and resistance for that given workout. This set should be 3 minutes and should be followed by a 5-minute rest prior to starting you workout for the day.
If you haven’t spent much time hanging recently you may surprise yourself and start the season stronger and more durable.
The Excel PT Climbing Lab exists to keep you climbing and improve your performance. We offer comprehensive injury management, video-based climbing analysis, and training plans.
Matt Heyliger, DPT, COMT of Excel Physical Therapy completed his Doctorate in Physical Therapy at Eastern Washington University in Cheney, Washington and is a Certified Orthopedic Manual Therapist. He has a particular treatment focus in the relationship of cervical/thoracic spine mechanics and upper extremity conditions. Matt treats climbers through integrating video analysis and specialized biomechanical assessments in the Excel PT Climbing Lab in the Bozeman, Montana clinic. An avid rock climber, telemark/backcountry skier and mountain biker, Matt regularly practices yoga and enjoys frequent adventures in the mountains with his family.
Running Skills: A Talent Or Ability That Comes From Training And Practice - By AJ Sobrilsky & Jason Lunden 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:
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.
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 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.
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
However you need us, we are here.
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:
Subscribe to our new Youtube channel. Help us share our channel with your tribe ➛
|
The Answer Is Load, What’s The Question? by AJ Sobrilsky, DPT, OCS
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:
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.
The Balancing Act of Avoiding Running Injuries by AJ Sobrilsky, DPT, OCS
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:
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.
Treating Chronic Pain by Megan Kemp, DPT, ATC, CSCSAre 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 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. |
COVID-19 - our updated policies and Virtual PT Visits Now Available
|
|
The Runner’s Arch Nemesis by Megan Kemp, DPT, ATC, CSCSSummer 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!
Megan 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.
Physical Therapy as a Means for Prevention 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!
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.
"Very friendly and respectful of needs." --Bozeman Patient
View more testimonials from Excel PT clients »
