Thanksgiving is right around the corner.  Are you still working on your menu planning?  Here is a great fall recipe that could be a wonderful side dish for any night, and certainly fits on the traditional Thanksgiving table as well.   

Ingredients: 

4 tablespoons unsalted butter
1/2 vanilla bean, seeds scraped OR 1 teaspoon vanilla extract
4 lbs mixed squash, seeded and sliced into 1/2 wedges (2-3 small to medium squashes, such as kabocha, delicata, red kuri work well)
3 sage sprigs and 10-15 sage leaves
salt and pepper to taste

Instructions:

Preheat your oven to 425 degrees.  In a small sauce pan combine the vanilla, butter and sage (sprigs or 2-3 leaves).  Cook on medium to low heat, stirring occasionally, until the butter browns and has a nutty aroma, about 5 minutes.  Remove from heat and discard the sage and vanilla bean.

Coat the squash with the butter and season with salt and pepper.  Roast for about 25 minutes, turning half way, or until the squash is golden and crisp in spots and tender. 

As the squash is roasting fry the remaining sage leaves.  This is a nice addition for the overall presentation of your squash, but also were a fun crunchy addition to the dish.   In a small saucepan heat 2 tablespoons olive oil on medium high.  Stir in the leaves and sauté until crisp, about 2 minutes.  Drain them on a paper towel.  Arrange the squash with the scattered sage leaves on a platter to serve.

Enjoy!

September might be the best time of year in Missoula for fresh local veggies, especially for a big juicy tomato.  The tomatoes we can enjoy now make me wonder why I ever buy one at the store in December!  So head on down to the farmers market to pick up a few nice looking tomatoes and a cucumber or two to make this classic and delicious salad.  This salad is very versatile, and can easily be tweaked to your liking.  For instance, trade out the feta cheese for some fresh mozzarella, or skip the cheese for dairy free.  I have also added some cooked quinoa to make a this a more hearty lunch.  It is also just as good the next day, it can be stored overnight in the fridge, but the next day it is best to take it out before eating to let it come up to room temperature.

Enjoy!

Ingredients:
2 cups chopped tomato
1 1/2 cups peeled and chopped cucumber
1/4 cup diced red onion
1/4 cup crumbled feta
3 tablespoons olive oil
1 tablespoon red wine vinegar (or to taste)
salt and pepper to taste

Instructions:
Mix all the ingredients together in a medium bowl, serve at room temperature.

Occupational Health promotes and maintains the highest level of safety and physical well-being for optimal performance within a specific job setting.  At Alpine PT, we offer several components to build a safe and effective working environment as well prepare and clear employees for best fitted positions.  Current research demonstrates significant reduction with on the job injury and unnecessary disability when occupational health is used for pre placement testing, safety in lifting, early interventions, and early active intervention if injury does occur.  Here are some frequently asked questions to help you understand what our offerings are:

What is a Pre Offer Work Screen?  An employer will offer a new hire a position that might require physical demands, to ensure safety for the new employee there is a physical exam or Work Screen that is performed.  These include job specific movements and tasks to assess the new employee's ability to complete the potential work tasks safely.  Physical Therapists and Exercise Scientists generally provide feedback and assessment on these tests then the employer is notified of the results and or any recommendations for the new hire to ensure safety upon starting their new role. 

What companies does Alpine PT work with currently in providing Work Screens?  NorthWest Energy, Montana Rail Link, Montana Schools Group InterLocal Authority, Dailey Meats, and others.  

How do companies find out more information about these offerings?  Visit the Alpine PT website's page about Occupational Health ; call our Downtown Clinic and ask for RJ; or send an email to info@AlpinePTmissoula.com
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Who is on the Alpine PT Occupational Health Team?  While all our talented PTs enjoy treating injuries related work; we have a specific team of staff members leading this area of specialty: Matt, Cole, Sam, and RJ.  If there are questions or recommendations or referrals around Occupational Health please feel free to reach out to this team at Alpine. 

What else does the Occupational Health Team offer besides Pre/Post Offer Work Screens?  There are many areas where PTs can help employers provide a safe and enjoyable workplace for their team.  Alpine PT offers onsite educational presentations, injury prevention and performance assessment testing, early interventions and consults, and onsite ergonomic assessments.  

Why is Occupational Health important?  By using professionals like PTs, employers can help keep their staff as healthy as possible and enjoy their jobs as well as being able to enjoy life outside of work.  Research shows that preventive steps in managing injury and early intervention for injury management reduces total costs of claims, limits days off work, and improves employee retention and moral.  The body is the most important tool out there - it is time to make sure we invest and take care of it!

If you are interested in more information about how Alpine Physical Therapy can contribute to the health of your business, please call our Downtown office at (406)549-0064.  

By Jess Kehoe

Curry is a very traditional flavor for Indian and South Asian cuisine, and can range from subtle to very spicy.  If you are not a curry fan, or have never tried it, this is a very mild version, and a great option to try out something new.  It is really dominated by the sweet coconut flavor and I love how it goes with the salmon, as well as how yummy the rice is drenched in this sauce.   

Ingredients:
2 tablespoons canola oil
1 medium red onion, halved and sliced 1/2 thick 
1 inch of fresh ginger, minced (about 2 tablespoons)
3 garlic cloves, thinly sliced
Salt and black pepper to taste
1/4 cup white miso
1/2 cup unsweetened, full-fat coconut milk
3 cups water
1 salmon fillet (about 1 1/2 lbs), cut into 2-inch pieces
5 packed cups of spinach
1 tablespoon fresh lime juice
Steamed rice for serving, such as jasmine or basmati

Instructions:
In a large pot, heat the oil on medium.  Add the onion, garlic and ginger, season with salt and pepper.  Cook until the onion softens, stirring occasionally for about 5 minutes.  Add the miso, then stir frequently until the miso is lightly caramelized, about 2 minutes.

Add in the coconut milk and water and bring this to a boil.  Lower the heat to a rapid simmer for about 5 minutes until the liquid reduces a bit.  Stir in the salmon and reduce the heat to medium low.  Simmer the curry until the salmon is just cooked through, about 5 minutes.  Turn off the heat and stir in the lime juice and the spinach.  Stir until the spinach wilts.

Serve over rice and Enjoy!

By Jess Kehoe

Do you have a farm share or CSA?  If so, and your family is like mine, the cabbage can sit in your refrigerator for weeks, since using little bits for tacos here and there doesn't take much.  Amazingly it seems to last for quite a while in there, needing only a little trim of the edges.  If it's time to use up that big head of cabbage to make way for the next one here is a pretty tasty and very easy recipe to try.  Even my husband agreed that it was surprisingly good, especially considering his less than enthusiastic initial reaction to my announcement of what was for dinner!

Ingredients:

2 tablespoons olive oil
4 sausages, sliced into 1/4 in thick pieces
1 small head of cabbage, about 5 cups, shredded (I used a mixture of red and green since that is what was sitting in my fridge)
1 small apple, sliced thinly
1/2 yellow onion, diced or thinly sliced
1-2 cloves of garlic, minced
2 teaspoons salt
1/2 teaspoon black pepper

Instructions:

Heat a large skillet to medium high.  Add the sausages and sauté, flipping frequently to brown them.  When cooked to your liking, remove them from the pan and set them aside.

In the same skillet, heat 2 tablespoons of olive oil to medium high.  Sauté the onions and garlic until onions begin to soften.  Add in the cabbage, apple slices, salt and pepper.  This may feel like it overflows your pan, but that's ok, it will cook down quite a bit.  Stir occasionally until the cabbage is close to tender.  This will take about ten minutes.

Add the sausages back into the pan and mix, cooking another 3-5 minutes to re-heat the sausage. 

Serve and enjoy!

By Bailey Lodato, PT, DPT

As runners we think of a number of different muscles that help propel us along our running path.  Quads and glutes often get all the glory when it comes to “runner legs” but our calf is arguably one of the most underrated muscle complexes in the body.
 
The calf complex is composed of three muscles: Gastroc, Soleus and Plantaris muscles. This trio is considered a biomechanically advantaged group within the human body. What does this mean? Think of your calf like a wheelbarrow where the load is in the middle between the fulcrum (wheel) and the effort (lift), we consider this a class two lever.  Your ankle functions the same way in relation to rising on your toes: the ball of your foot acts as the fulcrum, the weight of the body is the load and the effort comes from the contraction of the calf. In the same way the wheelbarrow allows us to move heavy loads with reduced effort, so too does the calf. Due to this biomechanical design, the muscle force needed to produce a heel raise is 1/3rd of one's body weight and is why this group of muscles is biomechanically advantageous.(7)  You can see my obsession with the calf.

Calves are inherently efficient but they require effort to keep fit over the lifespan. In relation to running, you lose ~4% ankle power every 5 years over the age of 20.(6)  These decreased mechanical outputs result in 13% reductions in stride length and running velocity by age 60 and predict 20% reductions by age 80.(6)

Are calf raises the anti-aging antidote? Not exactly. However, it is proposed that calf strengthening throughout the life span can attenuate the biomechanical deficits that come along with aging.(6)   Less than optimal strength in your calf complex places you at an increased risk for a myriad of running related or overuse injuries:

•    Achilles Tendinopathy
•    Calf Strain/Tear
•    Plantar Fasciopathy
•    Posterior Tibialis Tendinopathy
•    Shin Splints (Medial Tibial Stress Syndrome)
•    Stress Fracture

Consider incorporating a variety of plantar flexor strength exercises to attenuate your risk of injury and add external resistance as tolerated. 

• Bilateral calf raise > Single leg calf raise > Single leg calf raise on stair
• Calf raise on leg press machine
• Seated calf raise 

If you are looking for more guidance on strength training, help with a persistent problem in your calf, or any other issues with your running, contact any of our three clinics.  We have PTs skilled in helping runners at all 3 of our locations.



References:
1. Wright WG. Muscle training in the treatment of infantile paralysis. Boston Med Surg J. 1912;167:567-574.
2. Lovett RW, Martin EG. Certain aspects of infantile paralysis and a description of a method of muscle testing. JAMA. 1916;66:729-733.
3. Lunsford BR, Perry J. The standing heel-rise test for ankle plantar flexion: Criterion for normal. Physical Therapy. 1995;75(8):694-698. doi:10.1093/ptj/75.8.694
4. Hébert-Losier K, Newsham-West RJ, Schneiders AG, Sullivan SJ. Raising the standards of the calf-raise test: A systematic review. Journal of Science and Medicine in Sport. 2009;12(6):594-602. doi:10.1016/j.jsams.2008.12.628
5. Hortobágyi T, Rider P, Gruber AH, DeVita P. Age and muscle strength mediate the age-related biomechanical plasticity of gait. Eur J Appl Physiol. 2016;116(4):805-814. doi:10.1007/s00421-015-3312-8
6. Devita P, Fellin RE, Seay JF, Ip E, Stavro N, Messier SP. The Relationships between Age and Running Biomechanics. Med Sci Sports Exerc. 2016;48(1):98-106. doi:10.1249/MSS.0000000000000744
7. Neumann DA, Elisabeth Roen Kelly, Kiefer CL, Martens K, Grosz CM. Kinesiology of the Musculoskeletal System : Foundations for Rehabilitation. Elsevier; 2017.

By Jess Kehoe, DPT

For a hot summer day this is a super easy, yummy pasta salad that requires minimal cooking.  This would be a great side dish to bring to a summer BBQ or pot luck.  If you want to add some protein power to make a more hearty main dish you can easily add grilled chicken or a can of chick peas.

Ingredients:
3/4 cup pine nuts, or walnuts
15 drained, oil-packed sun-dried tomatoes.  Chop up 5 of them separately.
1/2 cup olive oil
1/3 cup water
1 1/4 teaspoons salt
1/2 teaspoon black pepper
1 lb fusilli or pasta of your choice
1/4 lb spinach leaves, shredded (about 2 cups)
1 cup halved cherry tomatoes
1/4 cup grated Parmesan cheese

Instructions:
Over moderately low heat, toast the nuts in a small frying pan, stirring frequently so as not to burn them, for about 5 minutes.  Remove from heat.  If using walnuts you can roughly chop them at this point.

In a blender or food processor (I used an immersion blender), put 1/4 of the nuts, the whole sun-dried tomatoes, the oil, the water, 1/2 teaspoon of the salt, 1/4 teaspoon of the pepper.  Puree until smooth.

Meanwhile, cook the pasta as instructed on the packaging.  Drain and rinse with cold water.

In a large bowl toss the pasta with the remaining toasted nuts, 3/4 teaspoon salt, 1/4 teaspoon pepper, the pesto, the chopped sun-dried tomatoes, the spinach, the cherry tomatoes and Parmesan.

Serve warm or at room temperature.

​Enjoy!

By Jess Kehoe

Enchiladas a usually a hit around our house, liked by the kids and the adults.  As fall sets in, a warm cheesy dinner coming out of the oven finally sounds good again!  My husband makes a creamy chicken version with green sauce that I should share one day, but I usually tend toward a veggie version in red enchilada sauce as shared here.  If you are strapped for time, you could easily pick up one big can of red enchilada sauce and skip the first step here...but it's not very hard to make your own sauce and it turned out to be quite tasty.  

Ingredients:
1 large yellow onion, chopped
2 bell peppers, chopped
2 cloves garlic, minced
1 jalapeno, seeded and chopped (or omit for less spice)
1 tablespoon chili powder
1 teaspoon cumin
one pinch of crushed red pepper
1 teaspoon smoked paprika
1/2 teaspoon oregano
1 teaspoon sugar
salt to taste
pepper to taste
1 15-oz can pinto beans, drained and rinsed
1 15-oz can black beans, drained and rinsed
8 8-inch corn or flour tortillas
12 oz shredded Monterey Jack Cheese (about 3 cups)

Instructions:
Preheat the oven to 350 degrees.

In a large saucepan, heat the olive oil on medium.  Cook the onion and bell pepper until soft and translucent, about 5-7 minutes.  Add the garlic, jalapeno, chili powder, cumin, red pepper, paprika, oregano, sugar, salt and pepper.  Cook, stirring, for 1 minute.  Stir in the tomatoes and remove from heat.  Set aside 1 cup of the sauce, blending the remaining with an immersion blender (or in a food processor or blender) until smooth.   Then return to the heat and simmer for 20 minutes.

Place the reserved cup of sauce in a large bowl.  Mix in the two cans of beans and 2 cups of the cheese.

Wrap half the tortillas in a damp towel and warm them up in the microwave for about 1 minute.  They should be soft and pliable.   Spread a thin layer of sauce on the bottom of a 9x13 inch glass baking dish.  Spoon about 3/4 cup of bean mixture into a tortilla and roll it up, arranging them in the dish.  Warm more tortillas as needed.  Top the tortillas evenly with the remaining sauce, then sprinkle the enchiladas with the remaining cheese.  Bake for 15-20 minutes, until the enchiladas are hot and the cheese is melted.

​Enjoy!

​

By Jess Kehoe

Need a quick grab and go breakfast, maybe a healthy after school snack for before practice, or maybe you're headed on a road trip and need some healthy finger foods for the car.  In any case making these little tiny frittatas in a muffin pan is easy and versatile for sure!  I've added the ingredients I used but feel free to experiment with other veggie combos, like mushrooms and cherry tomatoes, or maybe peppers and diced ham.  It's like a choose your own adventure!  Enjoy.

Ingredients:
8 eggs
1/3 cup milk
1 clove garlic, minced (or 1/2 teaspoon garlic salt)
1/2 teaspoon onion salt
1 teaspoon dill
1/4 teaspoon black pepper
1 cup shredded cheddar cheese
1/4 cup shredded parmigiana cheese
1 small zucchini, diced small
1/2 red pepper, diced small
two handfuls of spinach, chopped

Instructions:

Preheat your oven to 350 degrees.  Brush a muffin pan with oil or nonstick cooking spray, or use some silicone muffin cups.

In a large mixing bowl combine the eggs, milk, garlic, onion salt, dill and pepper, whisk together.  Using a small measuring cup pour a tiny bit of the egg mixture in each muffin cup, enough to just cover the bottom.  Then divide your veggies, cheese or other fillings into each cup.  Then pour the remaining egg mixture on top to fill each muffin cup.  I would advise doing a little at a time, so you don't run out before all the cups are full!

Bake for 20-22 minutes, or until the eggs are set.  Enjoy warm or room temperature.  Storing the remaining frittatas in the fridge.