Interview with one of OSR's Physical Therapists

Recently, Hannah Schultz, PTA at OSR, interviewed Meredith Butulis, DPT at OSR on what the new letters behind her name mean.


Question: What is a CIMT?
Answer: CIMT stands for Certified Integrated Manual Therapist. It is an advanced certification that Physical Therapists can earn.

Question: Does this mean that you perform manual therapy, like massage, on all of your patients?
Answer: No. I evaluate and treat each patient individually. The certification really helps a therapist develop a very high level of understanding on how to use taping, exercise, and muscle energy techniques all together to achieve a result. Most of my interventions involve the patient being very active. 

Question: How does a Physical Therapist earn this certification?
Answer: A Physical Therapist attends 140 hours of specialized classroom work, and then practices these techniques over a course of at least 3 years. After this, the therapist is eligible to attend a 4 day written, oral, and practical exam. Once all of these exams are passed at 80% or better, one earns the title of CIMT.

Question: How does this affect the way that you treat patients?
Answer: Because of this training, I view each injury in terms of how it affects the entire body more than I did previously. For example, if you have an ankle injury, I may also evaluate and select appropriate interventions for your hip and knee as part of your treatment plan.

Question: What is one of the most interesting things you learned during your training?
Answer: I learned the specifics of how the body is really "all connected." For example, there are times that I need to treat pelvis alignment in order to successfully strength parts of a shoulder. There are very specific tests and signs I look for to understand which situations this applies in.

Shoulder Treatment

Recently Ryan Koepp and myself attended the continuing education course, Evidence-Based Assessment and Treatment of Shoulder Disorders and Other Related Shoulder Pathologies.  The presenter was Robert McCabe, MS, PT, OCS who works for the Andrews Institute in Pensacola.

 During the course there were many topics covered.  Most of the topics were review as the day went on.  Many confirmed what we at OSR already practice with our treatment and management of shoulder disorders.  While at this conference I did take away some great new ideas.

• First, the presenter showed many manual therapy techniques for stretching the shoulder capsule and for promoting proper shoulder blade motion.  These I will definitely be incorporating into my practice.  
• Second, we were shown many different rehab exercises.  There were some exercises I would have never thought of.  Most of them were for shoulder/shoulder blade stabilization and activation exercises.  I can already say I have incorporated these new exercises in with some of my patients and they have loved them.    

Check out the Andrews Institute website.  They have some very informational material.  http://www.theandrewsinstitute.com/

This article was written by Andrew Ernst, ATR, CSCS, CES. Andrew is one of the Athletic Trainers at OSR Physical Therapy, Eden Prairie. Ryan Koepp is a Physical Therapist, and clinic director at OSR Physical Therapy, Eden Prairie.  

Who am I working with at OSR?

Coming into any clinic, a good question is "what are your credentials?" Sometimes, you might see an email from your provider and wonder, "what do those letters after his/her name stand for?" Here's some insight into the letters you see behind names at OSR Physical Therapy.



We have three types of providers: Physical Therapy, Athletic Training, and Personal Training/Fitness. Many of our providers have credentials in more than one of these areas. Often providers list only their highest credential for their degree, as well as any advanced certification.

For example, a Physical Therapist that has both a Masters, and a Doctorate in Physical Therapy will only list the Doctorate.

Here are the letters and meanings for our Physical Therapy providers:

• DPT--Doctor of Physical Therapy
• MPT (or MSPT)--Masters of Physical Therapy
• PTA--Physical Therapy Assistant
• CIMT--Certified Integrated Manual Therapist

Our Physical Therapists work primarily in the clinic. We work with many insurance companies, as well as having cash pay options.

Here are the letters and meanings for our Athletic Trainers:

• ATR--Registered Athletic Trainer
• ATC--Certified Athletic Trainer

All of OSR's providers that actively practice in the field of Athletic Training are both Certified and Registered. Our Athletic Trainers work on site at several sports clubs and dance studios, at the sidelines of many games, and in the clinic.

Here are the letters and meanings for our Fitness Providers:

• ACSM HFS--American College of Sports Medicine Health/Fitness Specialist
• NASM CPT--National Academy of Sports Medicine Certified Personal Trainer
• CES--Corrective Exercise Specialist (via National Academy of Sports Medicine)
• PES--Performance Enhancement Specialist (via National Academy of Sports Medicine)
• BB Pilates Certified--Comprehensive Studio Pilates Certification from Balanced Body, which is part of the Pilates Method Alliance

All of OSR's fitness providers have a CPT, CES, PES, and are metabolic technicians. This allows them to work with a broad range of individuals from post-rehab, to weight loss and general fitness, to high level athletes. Our fitness services are cash pay, and may be reimbursable through your HSA. You should contact your HSA provider to discuss your specific account and circumstances.

OSR's providers work as a team inside and outside of the clinic to help you achieve the best outcomes possible on the broad spectrum from on field injury, to clinical rehabilitation of injury, to health/wellness, and return to sport performance. Have a question about these degrees and certifications? Want to know more about the education that goes into a specific credential? Just ask by leaving us a reply! We'd be happy to answer your questions.

What do Physical Therapists do to help with shin splints?

In follow up to last week's post on shin splints, let's look at what Physical Therapists do to help resolve shin pain.

• Evaluate the contributing factors such as:
• muscle imbalances
• training patterns
• how your footwear matches your foot type and sport
• Treat the causes, including:
• modalities to decrease inflammation
• hands on techniques to decrease scar tissue
• possible recommendation for change in footwear or orthotics
• exercises to treat muscle imbalances identified
• working with you on how you perform your skill (i.e. running analysis)
• Work with you on appropriate training progressions

If a Physical Therapist thinks the cause may require further evaluation by an MD, your PT will work with you on identifying a provider that would be helpful in your specific situation/sport.

Common Running Injuries

Spring is officially here, and with this means it is prime running season.  Did you know females are more at risk for knee injuries related to running and novice runners are 2.5 times more likely to be injured compared to experienced runners?

Whether your goal is to prevent injury, improve your functional performance or decrease your race times, OSR Physical Therapy can help. OSR physical therapists Dana Birkholz, Rusty Wallman, and Josh Rolfes have completed continuing education courses with experts Jeff Taylor-Haas, certified orthopedic specialist from Cincinnati Children’s Hospital and Bryan Heiderscheit, associate professor and director of UW runner’s clinic and sports performance research at the University of Wisconsin. By reviewing the latest research and new treatment techniques, our physical therapists are ready to assist you in all of your running needs.

OSR Physical Therapy has a physical therapist at each of their three locations who are specially trained to diagnose and treat running injuries. With the use of video analysis and our expertise, we will be able to assist you in overcoming your running injuries which will allow you to increase your running performance without pain. 

• Common running injuries treated at OSR Physical Therapy include the following:
•  Anterior knee pain, also known as patellafemoral syndrome
• Iliotibial band friction syndrome 
•  Plantar fasciitis
• Shin splints 
• Stress fractures 
• Muscle strains, most commonly of the hamstring and calf muscles 
• Ankle sprains 
• Achilles tendinopathy 
• Knee meniscal injuries

For more information about running and how OSR can help check out these links:
Discounted Running Analysis
All about Running with OSR

Shin Splints

With track season back in full swing, we see many cases of "shin splints" at OSR Physical Therapy. The treatment for this condition depends on the cause. Many clues about the cause are generated from running analysis, as well as the location of your pain. Over the course of the next two weeks, we will discuss the different kinds of shin splints in more detail. For now, see if you have pain in any of the following areas.

If you need help with "shin splints" now, our Chanhassen facility offers a special discount on OSR's running analysis services. We also have multiple Physical Therapists and Athletic Trainers who are licensed to evaluated and treat your "shin splints," whether they are due to walking, running, dancing, sports, or almost any other known or unknown cause.

Tendonopathy, Tendonitis and Tendonosis

Tendonopathy, Tendonitis, Tendonosis.  Three frequently used buzz words in the sports medicine community, but what do they all mean, and how do they affect your care in Physical Therapy?  This post will define these three terms, and address what they mean when they come to healing and returning to your sport of choice.

Definitions:

Tendon: A connective tissue that connects muscle and bone.  The most common tendon issues come in the shoulder  - also known as “throwers shoulder” ; the knee  - commonly known as “jumpers knee” ; the elbow – known as tennis and golfers elbow; and the ankle – known as Achilles tendonitis.  It is important to note, however, that tendons exist throughout our bodies and these injuries can happen to any of them.

Tendonopathy is an umbrella term to cover any problem with a tendon of the body.

Tendonitis – is the first onset of pain in a tendon.  It is often noted to be swollen, painful with, and without activity and  painful to touch.  This typically lasts 3-7 days.  

Tendonosis – is a more long standing issue with the tendon.  This can follow a tendonitis condition and is often related to pain at the start of activity, and after activity is completed.  It is important to note that after the tendon is “warmed up” the pain may often go away.

Initial treatment for both tendonitis and tendonosis should follow the RICE principle:

R – Rest – This rarely means complete stopping of you activity, but it is important to note that your tendon is not able to withstand the workload you have been placing on it, and that is why it is injured.  We need to rest the painful area relative to the workload that injured it in the first place.  In the case of a runner, for instance, decreasing mileage for a period of 1-2 weeks may be sufficient.

I – Ice – The injured body part will benefit from the anti-inflammatory and the pain relief benefits of ice.  Typically, 10-15 minutes of ice several times a day is sufficient.

C- Compression – when convenient, gentle compression with an ace bandage or supportive elastic brace will provide pain relief for the injured tendon.

E – Elevation – combined with ice, elevation will provide relief of any swelling or fluid that may build up in the injured area, particularly if it is the knee or the ankle that is sore.  

If the initial 1-2 weeks of self-treatment with these recommendations is not successful, it is recommended that you contact a health care provider, as your injury may be significant enough to require additional treatment, therapy, or exercise prescription.