Welcome

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Welcome to Health and Fitness 101, a blog for people who enjoy the Montana lifestyle.
The aim of our blog is to interpret, distill, and then deliver to you the threads that bind physical medicine with applicable health and fitness ideas and principles.
It's all about helping to connect the dots that foster optimal human function and, ultimately, superior performance. Feel better. Perform better.

Missoula Area Events

Dance Medicine Expert Recounts Presence at the Nutcracker Performances

Kristi Moore, a dance rehabilitation specialist with Alpine Physical Therapy, was onsite this past weekend for Garden City Ballet’s Nutcracker working with dancers of all ages.

Moore states, “It was a thrilling experience to help Missoula’s dancers with this annual event!  The hard work the dancers put into this production is truly amazing and it shows in the wonderful performance they deliver.”

Kristi was there to answer questions, give advice, tape up dancers and help them through the six performances.

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Dance is likely one of the most demanding activities an individual can do, for it requires an enormous amount of strength and grace to perform and yet make it look effortless. Getting through a full week of six hours a night rehearsal leading up to two performances per day for three days takes dedication and a love of dance!

We applaud all of the dancers who participated in this year’s Nutcracker, and all the parents who support and take care of their dancers!!  Kristi was honored to be on site to help the many dancers and enjoyed every minute!

For more information on Alpine’s Dance Medicine specialty, click here.

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Here’s How People Look Before and After Being at Alpine PT

I received that the Schmidt family is doing well. Sam wanted me to pass the following information along to you.

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Hi All,

Robin is a growing. ..barely 10 wks and pushing 16 pounds (his sister was barely 19 pounds at a year!)…..needless to say we are keeping out of trouble and really looking forward to the holiday party! Brent started the official count down to the bash by kicking it off with a warm group hug! Yeah!!!

Check out the expressions on Robin’s face. Without a doubt, the first is the expression on the face of people before being treated by Alpine. The second is their face after they receive treatment by Alpine!

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Vote for Missoula’s Choice for Physical Therapy

Hey Everyone!

Help us to continue to be large (we’re Missoula’s largest outpatient PT company) and take charge! Alpine Physical Therapy is Missoula’s Choice for outpatient physical services in Missoula . . . if not the world! Help us nab that top spot again.

Please click here to vote for Alpine Physical Therapy as your choice for physical therapy in Missoula! (It actually says “Physical Therapist,” but they want a PT business . . . Alpine.)

Please invite your friends to do so as well!

You must fill in your contact information and answer at least 20 of the categories. (Note: Your information will not be used for future marketing or sold.)

Thanks for making Alpine THE TOP CHOICE for PT in Missoula for the second year in a row! The deadline to cast your vote is December 31st.

 

Again, click here for the link.

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Pelvic Pain? Physical Therapy Specialists in Missoula Offer Help

On one hand, the notion of pelvic pain may seem a bit “off topic.” On the other, if you have it, you’re not alone and you deserve answers.

Were you aware there are two specialized physical therapists in Missoula who offer help for this condition? Tara Mund and Morgan York-Singer, both Doctors of Physical Therapy at Alpine Physical Therapy, continue to help area women with a host of different conditions. They are compassionate and caring experts in the treatment of pelvic pain as well.

Meet Tara and Morgan

Meet Tara and Morgan

Here’s an excerpt from the Her Health webpages on the topic of pelvic pain.

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Pelvic pain can be described as an ache, burning or sharp discomfort located in the abdomen, pelvis, or perineal area.  It usually is present for greater than six months and may prevent or interrupt sexual intercourse and may make gynecologic pelvic exams uncomfortable.

Pelvic pain can be caused by several problems including muscular imbalances within the muscles of the pelvic floor, trunk or hips, pelvic joint dysfunction, tender points or trigger points located in the deep hip muscles or pelvic floor, pressure on nerves through the pelvis or dysfunction of the muscles related to bowel and bladder function.  It can also be attributed to the presence of scar tissue after pelvic or abdominal surgery.

Patients may describe pain through the pelvis, hip, back or tailbone including difficulty sitting or wearing tight clothing. Patients with pelvic pain may also experience disruptions in bowel or bladder habits such as frequent urination, incontinence, constipation, or straining with bowel movements.

How Can Physical Therapy Help?

Physical therapists are trained in the assessment and treatment of muscular imbalances, movement analysis, and joint dysfunction. They commonly treat impairments including joint restrictions or instability, muscular tightness and weakness, as well as motor control difficulties.  The Her Health physical therapists at Alpine have additional specialized training in the assessment and treatment of pelvic floor dysfunction.

A thorough examination is necessary to design an individualized plan of care for the patient suffering from pelvic pain.  Treatment may include manual techniques to address muscular restrictions as well as motor control and breathing strategies for relaxation. Targeted strengthening may be included to improve strength, muscular endurance, and correct faulty muscle recruitment patterns during the rehabilitation process.

For more information on the services available through Her Health at Alpine Physical Therapy, click here.

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Urinary Incontinence? Physical Therapy Specialists in Missoula Offer Help

On one hand, the notion of urinary incontinence may seem a bit “off topic.” On the other, if you have it, you’re not alone and you deserve answers.

Were you aware there are two specialized physical therapists in Missoula who offer help for this condition? Tara Mund and Morgan York-Singer, both Doctors of Physical Therapy at Alpine Physical Therapy, continue to help area women with a host of different conditions. They are compassionate and caring experts in the treatment of urinary incontinence as well. #AlpinePT

Meet Tara and Morgan

Meet Tara and Morgan

Here’s an excerpt from the Her Health webpages on the topic of urinary incontinence.

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Urinary incontinence is the involuntary loss of urine.  There are several types of urinary incontinence:

Stress Incontinence is the leakage of small amounts of urine when there is increased intra abdominal pressure.  This can happen with exercise, coughing, sneezing, laughing, lifting or other activities.

Urge Incontinence is the leakage of urine when a person feels the sudden strong urge to urinate.

Mixed Incontinence includes symptoms of both stress and urge incontinence.

How Can Physical Therapy Help?

Because many symptoms of urinary incontinence are caused by pelvic floor weakness and/or dysfunction a thorough examination by a specially trained physical therapist is appropriate.  Her Health physical therapists will evaluate your pelvic floor muscles and design an individualized plan of care to help you gain control over your urinary symptoms.

Treatment will include: proper motor control activation and relaxation of pelvic floor muscles and exercises to stretch or strengthen the pelvic floor and other important muscles.  Additional treatment may include education on dietary influences on bladder irritability, ways to decrease urinary urgency and frequency and possible advice on modifications of behaviors that may aggravate your urinary symptoms.

For more information on the services available through Her Health at Alpine Physical Therapy, click here.

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Alpine Receives Sponsor Accolades from MT Alpha Cycling

In mid-November, Alpine Physical Therapy was honored with accolades and a team picture from MT Alpha Cycling amid great food at drink at Alpine’s Downtown clinic.

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Brent Dodge owner of Alpine PT was present to receive the award and responded by stating: “MT Alpha Cycling is a powerhouse group of adult and junior female athletes who put in a ton of hard work again this year. They are clearly on fire about cycling and being a part of this incredible all-women’s cycling group. Alpine’s opportunity to sponsor this fantastic group of people is another highlight of being involved in Missoula’s athletic community!”

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The Physical Therapists of Her Health at Alpine PT

Providing specialized care for women in Missoula is a passion of the Her Health physical therapists  at Alpine PT.

Her Health therapists Tara Mund, DPT and Morgan York-Singer, DPT are the inspiration of this clinical specialty and provide excellence in this burgeoning field.

Tara has long had a special interest in focusing her career on the expressed health needs of women. Her spirit and genuine caring leadership have infused the team, and Alpine is now recognized by doctors and clients as a leader in providing physical therapy services for women.  Morgan holds this same passion and commitment in the treatment of women’s health needs.  She returned recently to her hometown after establishing a similar practice in Bozeman, Montana, to join the Her Health team to expand this outreach in Missoula and our surrounding communities.

For more information on Her Health, click here.
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Alpine PT Sponsors MAPS Spine Rehab Seminar

Alpine Physical Therapy hosted a hands-on physical therapy seminar addressing neck and back pain management techniques. Our presenter was Colette Seyman, an Australian-trained manual therapy specialist based in California. In total, 24 physical therapists from Alpine and from a total of three states were present for this three-day Maitland Australian PT course held at our south location within the Peak Health & Wellness Center on Blue Mountain Road. Courses like this are offered through Maitland-Australian Physiotherapy Seminars.

Our professional staff in attendance included Antara Quinones, Brace Hayden, Dennis McCrea, Gary Gales, Jess Kehoe, and Morgan York-Singer.

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This intensive seminar is one of a group of core classes toward manual therapy certification. Specifically, this recent course covered approaches to improving spine mobility to reduce pain and improve the function of our patients. We were particularly interested in this course as we tend to work with a lot of Missoula’s population with persistent and challenging neck and back issues.

These manual techniques can be highly effective and specific to each region of a dysfunctional or irritable spine, but they require a lot of background and hands-on practice.  For more information on our approach to helping patients with neck and back pain, click here to view our Spine Clinic at Alpine.

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Alpine PT Connects with Runner’s Edge

Alpine Physical Therapy connected this week with Ander’s Brooker, owner of Runner’s Edge in Missoula. Anders shared with us many new styles and methods of improving comfort and efficiency in runners. With so many new styles and shoes on the market, it was super helpful for our physical therapists to hear first-hand from Anders all the ins and outs of the new gear.

We’re looking forward to collaborating on a new idea together, a spring running expo, which we plan to launch and deliver within the Peak Health and Wellness Center. Keep your eyes open for this event, as it will be a tremendous outreach to our area runners. We plan to include talks by our running specialists at Alpine PT, along with a discussion of footwear by Anders. Other topics will also include training concepts and strategies. And we’ll have other guest speakers for topics on orthopedics, women’s health, and injury prevention.

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Review Article Sheds Light on Improved Surgical Technique For Hammer Toe

Special thanks to star physical therapist Antara Quiñones of Alpine Physical Therapy for providing this write up on a recent article from the Journal of American Academy of Orthopedic Surgery.

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Toes are like teeth- you take them for granted until they hurt and then you realize how much you rely on them and are amazed at how much pain they can cause.  Toe instability resulting in a rigid deformity is a common foot problem.  A recent review article speaks to new knowledge of toe instability and a surgical technique that should be utilized—specifically, repairing the plantar plate.

In a healthy foot the tiny muscles of the feet and toes along with ligaments on the sides of your toe joints (collateral ligaments) and a thick piece of fibrous tissue on the pad of your feet and toes, called the plantar plate, help to resist the forces your toes undergo during walking and running.  The second toe is most vulnerable to hyperextension because there is no muscle responsible for resisting your second toe moving towards your big toe. Authors of this review found that the plantar plate is primarily responsible for the stability at the 2nd toe joint.  If this plantar plate is torn, due to abuse or trauma, and not repaired the toe instability becomes worse and typically results in a crossed toe.

Toe deformities go by various names depending on the direction the toe goes, but generally speaking a bent toe is called “hammer toe” which can turn into a toe stuck under or over the adjacent toe.  Any deviation from a straight toe is an indication of joint instability and should be addressed to prevent future pain and walking difficulty.

Hammer toe is caused by outside pressure (like high heels), inflamed joints, and autoimmune diseases. Predisposing factors include genetics, a longer second toe, flat feet, and an already poorly aligned big toe.  Curled toes, or hammer toes, most often happen to women older than 50 years old whose feet have been pressed into high heeled shoes with narrow toe boxes.  Men and younger people can also develop hammer toe, however it is more rare.  Often, these deformities are ignored until they become “fixed” or the bones have fused into place. Fused toes are problematic because as we push off with our back foot while walking the toes must bend and tolerate 40% of our body weight.

Symptoms of toe instability are pain on the bottom of your toe where it meets your foot, toe swelling and numbness, a feeling of “walking on marbles,” and a gradual change in the direction of your toe towards encroaching on its neighbor.  It may be uncomfortable to walk barefoot or feel better to walk on the outsides of your feet. Imaging, such as x-rays or MRI, can diagnose hammer toe.  However two simple tests combined show good diagnosis results: a “drawer test” to test the mobility of the joint, and trying to pull a piece of paper out from under the toe in standing.

Treatment of hammer toe depends on the extent of the instability of the toe joints.  Often, people do not seek treatment until the toe has completely crossed under or over and has become rigid. Conservative treatment is moderately effective for early joint instability and includes shoe modification (lower high heels, wider toe box, more cushion), pads placed in the shoes or rocker bottom shoes to redirect the forces across the foot during walking, or steroid injections at the joint (keeping in mind that any steroid relieves pain but does disturb the already fraying tissues). Keeping your foot, ankle, and calf muscles strong can also help, as well as checking in with a physical therapist to help correct any faulty movement patterns further up the chain.

Surgery is a common option, especially for more advanced stages of hammer toe. Two main approaches are used–one accessing the area from the sole of the foot and the other from the top of the foot.  Surgeons trim any unhealthy tissues and suture any obvious tears in the plantar plate and collateral ligaments.

In the past the collateral ligaments have been the primary tissue repaired.  However, authors found better outcomes with surgery prioritizing plantar plate repair along with collateral ligament repair.  They found that this helped significantly with lasting deformity correction and improvement in pain and a person’s ability to function.

Jesse Doty, M.D. Metatarsophalangeal Joint Instability of the Lesser Toes and Plantar Plate Deficiency. In Journal of American Academy of Orthopedic Surgery. April 2014. Vol. 22., No 4. Pp235-245.

For more information, visit this topic module on our clinic website by clicking here.

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