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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

Balance Problems? Don’t Fall for Anything

Falls are a big deal to many older adults with over a third of the +65’ers falling annually. According to the Centers of Disease Control and Prevention, a fifth of these falls results in a traumatic injury, and many of them (like one every 29 seconds) leads to their demise.

We’re not only paying for these falls with our lives, but medical expenses from falls cost over $28 billion per year.

Alpine Physical Therapy makes an effort to be a part of the good news on this threatening topic by reaching out to reduce falls in our community. We participated in a multi-agency collaboration (MonTECH of the Rural Institute, UM’s School of Physical Therapy, and the National Council on Aging) again this year for National Falls Awareness and Prevention Week.

We offered free balance and falls-risk screens to all interested this year at the Peak Health and Wellness Center’s first annual health fair last Friday evening (9/19/14). The event was a success with over 10 older adults screened and subsequently educated on local falls prevention classes, physical therapy options, balance and strength exercises and their relative risk.

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Alpine PT is pleased to be a part of Missoula’s falls reduction network and reminds the community that we offer free balance/falls-risk screens year round at our three locations.

For more information on this important topic, visit our clinic website on the topic of our Vestibular and Balance Clinic by clicking here.


Alpine’s Presence at the First Annual Health Fair at the Peak Health and Wellness Center

Most Friday nights are spent watching a movie as a family, perhaps going downtown for dinner and a night out, or enjoying time with friends and family. Several Alpine physical therapists and staff chose to spend their Friday night at the first annual Health Fair at the Peak Health and Wellness Center on Blue Mountain Road. Joining the fitness and training staff from the Peak, Alpine Physical Therapists helped spread the word of wellness to the Missoula community.

Brace Hayden was joined by several University of Montana PT students providing free balance testing at the event. Morgan York-Singer and Leah Versteegen educated participants of the importance of their core, and Matt Schweitzer was joined by Ana Soulia providing postural guidance for daily life and exercise. Participants ranged from young to old; some were current members at the Peak, while others were simply interested members of the Missoula community.





Kayli Julius, the coordinator of the event and a Health Coach at the Peak envisioned a community gathering to promote the concept of Health and Wellness. Vendors included local businesses such as Great Harvest and Lolo Peak Brewery. Fitness instructors from the Peak provided free 10 minute classes, such as Oula , Spinning, Pilates, and Yoga. Staff members from the Spa at the Peak were present to give massages and free wax services.

The night was a success with participants finding new ideas and approaches to living a healthy lifestyle. Special thanks to Alpine physical therapists who led the way with their guidance on improving overall wellness. We at Alpine are already looking forward to next year’s Health Fair!


Alpine’s Presence Runs High at this Year’s Mountain West Cross Country Classic

The Alpine tent was up and ready for action this past Saturday for Montana’s largest annual cross country meet, The Mountain West Cross Country Classic.  The event draws youth from all over the Northwest for a 3 mile run for High School athletes and a 1.3 mile run for Middle School athletes. The sun was out, the air was clear of smoke, making it a spectacular morning for such a great event.

Physical therapists Kristi Moore and Jamie Terry spent the morning taping, consulting on injuries, and triaging athletes to local Missoula Emergency Services. We were really fortunate to have support from Athletic Trainers Emily and Winter, Physician Assistant Kris Provo and Alpine Aide Maddie with the constant hustle in the medical tent. Trying to keep athletes doing what they do and injury free is a top priority here at Alpine, so it was an honor to spend the morning with these runners and see them excel.

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Highlights from the morning, a huge upset in the female varsity run with Freshmen Anne Hill of Glacier upsetting Senior and reigning champ Makena Morley of Big Fork with a time of 16:39:64. In the JV race, local 9th Grader of Hellgate, Isaac Smith, came out on top with a time of 16:27:99. It will be really exciting to see what these two do over the next 3 years.

A big thank you to Michele Chalmers and the Mountain West Track Club for having us again this year. We love being a part of this community event and are looking forward to it again next year!


Alpine Feels the Beat of Fall in the Great Outdoors

It’s that time of year again where people get up in the wee hours of the morning and head out to hunt, which for many adds up to a big long hike. So many of these folks feel like super heroes with heightened senses for the task at hand in the great outdoors.

People so often take for granted what it takes to get out and make this happen.


Experiences like these get everyone at Alpine Physical Therapy upbeat, for it’s our aim to ensure that everyone gets out and enjoys all that fall here in Montana has to offer, including healthy hunting days.

Best to our area hunters!


Is My Neck Getting Stiffer Every Year?

Special thanks to star physical therapist Brace Hayden, DPT, CSCS of Alpine Physical Therapy for providing this write up on a recent article from Spine.


Our neck mobility seems to gradually get worse as we celebrate birthdays and suffer our share of accidents and uncomfortable hotel pillows. The garden variety pain or achy stiffness in the neck, categorized in the healthcare world as ‘nonspecific neck pain’ sends a lot of people to their care providers for some sort of treatment and medical relief. In order to best assess neck complaints, providers perform an examination of the spine. The physical therapist (or other provider of choice) will measure their range of motion (ROM), as in many cases one of the goals for patients with nonspecific neck pain is to improve the neck’s mobility.

Normative values for the neck’s mobility are memorized by clinicians during their respective education, so relative stiffness measured in degrees, documented and treated for hopeful improvements. For example, we learned in PT school that the “normal” neck flexes and extends about 60 degrees, rotates 90 degrees and side bends 45 degrees. But, “normal range of motion” changes with age, and thus ‘normal’ for a 20 year old is quite a bit more generous than the age-reduced ‘normal’ for a 60 year old.

Enter the work of Dr. Swinkels and his team of researchers from the Zuyd University’s Department of Physiotherapy in the Netherlands. They recently published a paper on their investigation on the range of motion differences in the cervical spine as we age. They studied four hundred people without neck issues and quartered the data set with 100 for each decade of age from 20 years to 60 years and in each quarter subgroup. Each subgroup also had an even balance of genders with 50 males and 50 females. The mobility of the neck was measured with a special cervical range of motion device called the ‘CROM’ (see Figure 1). Swinkels’s team crunched the nitty-gritty analyses of variance, linear regressions and even further dredged the data with Scheffé post hoc tests to investigate the differences in neck mobility between the decades of age and any possible relationships of age and/or gender.

As one may expect, they found that age does have a significant effect on active ROM of the neck. Table 2 beautifully illustrates the diminishing trend of neck ROM in healthy adults without neck pain. Recall the “normal” ROM for neck flexion we committed to memory was 60 degrees. This normal mobility of 60 degrees in Swinkels’s study was assessed as typical for 20-somethings, but each decade men and women evenly lose a degree or two, until the 50-something decade. 50 years and older, active ROM declines greatly in all directions except neck extension and side bending. Neck flexion on average is reduced 12 percent (7 degrees) to 53 degrees.  Clinically this is relevant, as we in the physical therapy profession tend to council a lot of people on improving their stiff neck’s mobility. In all due fairness, the “new normal” should be on an age-adjusted sliding scale when goal setting for target neck mobility. ]

Raymond A. H. M. Swinkels, PhD et al. Normal Values for Cervical Range of Motion. In Spine. 2014, Volume 39 , Number 5 , pp 362 – 367.



Alpine’s Over 45 Men’s Softball Team Schools Their Rivals!

We had to beat our arch rivals twice on the 18th of August to take the title for +45 B division champs-   So we did! 6-5 and 18-5 for a great end to Alpine’s season. Go Team!

Alpine PT Attains 100% National Association Membership

We’re proud to announce that Alpine Physical Therapy has once again attained 100% membership among its 15 physical therapists in the American Physical Therapy Association (APTA).

Our national association will recognize Alpine for this accomplishment in APTA publications and on their website, www.APTA.org. In addition they will post Alpine’s name on the Facility Challenge Wall of Fame at the annual APTA conference this year. We fully support our association’s efforts to advance the physical therapy profession.

For more information about our commitment to our community and our profession, please visit our website by clicking here.

Go Team Alpine!



Running to Your Own Rhythm

There are many of you who are winding down on you training season, and many who are training for fall races. In our day and age of technological gadgets we use watches, GPS devices, heart rate monitors, and many other devices. They can help you determine if you are in a zone, keeping pace, and going far enough for your training.

This can be helpful for beginning runners to know they are training appropriately for a new distance. They can help the seasoned runner know if they are maintaining a certain level or if they are improving. However, I have a challenge for you. Take one run per week (only one) and just go for a run. Listen to your breathing and how the run is feeling in your body.

If you feel good and want to push it go a little faster or a little further. If your body is recovering from your last run and is feeling like you need to slow down, do it. There has been much research done about perceived exertion and how accurate this can be in determining the level you are exercising at (compared to a heart rate monitor). I recently did this and remembered why I love to run. Enjoy being outdoors and exercising to help both your mental and physical being. I found it made me look forward to my next run.

As a Physical Therapist, many of the running injuries I see are from over training issues. If we occasionally take the time to listen our bodies will tell us what we are capable of doing and we may be able to avoid pushing into an injury. These technological advances have a purpose and can help you achieve your goals, but also listen to what your body is telling you. So go for a run and have fun!

Kristi Moore, MSPT
Alpine Physical Therapy, North
2965 Stockyard Rd.
Missoula, MT 59808
(406) 541-2606

A Summary of Treatment Guidelines for Knee Osteoarthritis

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.


Every 5 years or so the American Academy of Orthopedic Surgeons (AAOS), along with a cohort of other professions (like physicians and physical therapists) publish a guideline to treat certain conditions based on the latest and greatest evidence.  These guidelines offer a quick look into what’s proven to work, what does not work, and what still needs to be further investigated.  Below are the items that the AAOS recommends for the most up to date treatment of knee arthritis.

People with knee arthritis should:

1. Routinely take part in a strengthening program, neuromuscular education (or using techniques to restore balance, improve coordination and fine tune awareness of where your leg is in space), perform low-impact aerobic exercises, and keep physically fit to national standards in regards to heart health and body weight.

2. Maintain a body mass index (BMI) of less than 25.

3. Use nonsteroidal anti-inflammatory drugs (oral or topical) or tramadol to help with symptom management.

The following are NOT recommended for treatment of knee arthritis:

1. Acupuncture

2.Lateral wedge insoles are not supported in the literature.  This being said, however the recommendation is moderate and patient preference should be kept in mind.

3. The use of glucosamine and chondroitin.

4. The injection of hyaluronic acid into the knee joint.

5. Performing an arthroscopy with lavage and/or debridement in which the fluid of the knee joint is removed, the joint is washed, and any loose bodies or debris are removed.

6. The use of needle lavage where saline is injected into the joint and then removed in attempts to wash the joint and remove inflammatory factors and debris.

7. The use of free-floating (not cemented or screwed into place) interpositional devices in the inner knee compartment to alleviate pain and mimic meniscus function.  (This was a general consensus recommendation due to the lack of research available for these devices.)

Evidence is inconclusive for the following due to either lack of available evidence or inconsistencies in the studies that have occurred.  Practitioners should be on the lookout for future evidence, but in the meantime decisions regarding their use should be influenced by their clinical judgment and patient preference.

1. The use of physical agents, such as electrical stimulation and ultrasound.

2. Manual therapy.

3.  Valgus knee brace (to unload the inner knee compartment).

4. The use of acetaminophen, opioids, or pain patches.

5. The use of injections into the knee joint of corticosteroid.

6. The use of growth factor injections and/or platelet rich plasma.

7. A valgus-producing proximal tibial osteotomy, or bone shaving that changes the direction of forces across the knee joint to relieve pressure at the inner knee.

As the evidence changes and our knowledge evolves, it is good to keep the AAOA standards in mind and to be on the look out for future recommendations.

David S. Jevsevar, M.D., MBA. Treatment of Osteoarthritis of the Knee: Evidence-Based Guideline, 2nd Edition. Journal of American Academy of Orthopedic Surgery. September 2013. Vol 21, No 9. Pp 571-576.

For more information, visit our topic module on Knee Osteoarthritis by clicking here.

Alpine PT Welcomes Home, Morgan York-Singer, DPT

Morgan York-Singer, DPT has joined Alpine Physical Therapy.  The “Her Health” program at Alpine PT has steadily grown over the past six years, and Morgan’s arrival will allow Alpine to serve more women’s health patients.


Morgan’s specialty areas include Women’s Health (incontinence, pelvic pain, pre-natal/postpartum care) and sacroiliac joint dysfunction.  She earned her Doctor of Physical Therapy degree from the University of Montana in 2009, and after practicing in Bozeman for several years, returns to her home town of Missoula with her family.

Morgan enjoys hiking, biking, skiing, and spending time with her family.