By Jess Kehoe

We made it though the Holidays, phew!  This December was not my best, in terms of exercise, and I nearly ate an apple pie all to myself that I was going to share with friends who got the flu.  So, this January I've got all kinds of plans to shape up my game; get back to lifting, running, yoga and eating "better". This recipe here is a pretty good start.  It's packed with veggies, beans and good flavor.  There is a nice mild heat to it, but my 5 yr old, who did repeatedly tell us that "it is spicy" still ate most of her bowl.  If you like more heat you can add a second jalapeño and another 1/2 tsp of red pepper flakes.  

Enjoy!

Recipe adapted from @jennifer.garner and her #PretendCookingShow where she credits @sara_fostersmarket.  Will feed 6-8 adults.

Ingredients:
1 Tbsp olive oil
1 onion, chopped
2 medium sweet potatoes, 1/2 in diced
1 red bell pepper, diced
1 green bell pepper, diced
1 jalapeño pepper, seeded and diced pretty small
3 garlic cloves, minced
3 Tbsp chili powder
2 tsp ground cumin
2 tsp dried basil
1 tsp dried marjoram
1/2 tsp crushed red pepper flakes
3 bay leaves
1 tsp salt
1/2 tsp ground black pepper
6 cups veggie broth  (I used chicken broth, because that's what I had)
1 28oz can chopped tomatoes
1 12oz beer
1/2 cup barley or bulgur
2 15oz cans of black beans, rinsed and drained
Garnish: your choice of cilantro, scallions, avacado, sour cream, cheese, lime wedges.

Cooking Instructions:

Heat the olive oil in a large saucepan over med heat until sizzling hot and add the onion. Reduce to low and cook, stirring often, ~10 mins. Add sweet potatoes, bell peppers and jalapeños, stirring occasionally, 5 mins more. Add the garlic and cook, stirring, 1 min longer.

Stir in the chili powder, cumin, basil, marjoram, red pepper flakes, bay leaves, salt and pepper and cook ~2 min. Add broth, tomatoes, beer and barley and stir to combine, bringing to a low boil.

Reduce to simmer and cook uncovered, stirring occasionally, -40 mins.

Remove bay leaves from chili and discard. Add beans, stir to mix and continue to cook, stirring occasionally, until beans are heated through, ~15 mins.

Serve warm with wedges of lime to squeeze into chili and garnish with your favorites, maybe even have some corn chips on the side.  Delish!

As we head into the season of darker and shorter days; slippery snow 'n ice on the walk ways; and autumnal wet leaves everywhere; Alpine PT has collected the top 10 pro-tips from our PT staff on their thoughts for falls prevention.  The CDC also puts out a lot of helpful information on falls prevention on their website to aid in risk reduction for our potentially vulnerable, older adults in our community. 

1. To our fellow health care providers, don't feel you have to reinvent the wheel on assessing falls risk. The CDC STEADI test can accurately measure falls risk for independently living older adults. The website has resources for patients including  brochures, educational explanations on ways to reduce risk for falls, and empowerment tools to promote independence with age.  
2. A daily balance practice is one of the best falls prevention investments you can make. Be sure your balance exercises are sufficiently challenging. Ideally each challenging drill should be at the "edge of success." If it's not difficult enough or too difficult you won't benefit from the drill. Make sure each drill has you "wobbly, but able to safely recover". (eg. If your single leg stance drill is too hard, try putting your opposite toe down. Conversely, if it is too easy, try closing your eyes.)
3. Improving balance requires 2-3 short (2-3 minute) sessions per day. Steady balance is a multiple system integrated skill.  A few minutes of balance practice a few times per day can go a long way. Try pairing balance drills with other tasks you frequently do in a safe place (eg. while brushing your teeth or while waiting for your coffee or tea to brew).
4. Perform a seasonal home safety check for potential fall hazards. The CDC has a home safety checklist that helps identify things like thick edged throw rugs and
   insufficient lighting for those night time bathroom runs.
5. Up your dynamic balance improvement game by taking a fitness class at a local gym or a Lifelong Learning Center fitness class.
6. Don't wait until you have already had a few falls, be proactive. There is certainty with the aging process that our balance tends to gradually get worse each decade after 30 years.  Start to work on your balance before you are having difficulty with it. Start today by getting sufficient cardiovascular exercise, strength training and performing balance drills to reduce the likelihood of a traumatic injury from a fall.
7. There are many tools that help you get a better/safer walking or hiking workout and reduce your falls risk.  If you are able to walk farther, have less joint discomfort, and better your balance using a tool (eg. trekking poles or a cane) use them!  Wearing shoes indoors and outdoors is also recommended as wearing slippers or going barefoot has a higher likelihood of causing falls. 
8. Have your health care provider or pharmacist review all the medicines you take, even over-the-counter pills. Some medications or combinations of meds, can make the aging adult more sleepy or dizzy and can cause falls.
9. Get in for an annual eye exam. There is a chance your vision has changed, you may have a condition like glaucoma or cataracts that limit your vision. Poor vision and wearing bifocals/trifocals can increase falls risk.
10. If you are unsure of your falls risk, the National Council on Aging has a Falls Free Checkup with a helpful online questionnaire tool that assesses your relative risk. 

If you are concerned about your balance, Alpine PT is offering free falls-risk screens at all 3 clinics throughout the month of November. Please feel free to contact us to schedule a free screen.  We will also be offering a few short presentations and screens during senior group fitness classes at the Peak.

Contributors:  Brace Hayden, DPT; Colter Brown, DPT, Leah Versteegen, DPT, Kristina Pattison, DPT, Angela Listug-Vap, DPT, Dennis McCrea, DPT, Antara Quinones, DPT, Matt Schweitzer, DPT.

By Jess Kehoe

This is one of my all time favorite recipes.  It is an oldy from my mom's original Moosewood cookbook, which is full of stains from 40+ years of use.  For those of you who don't' know what the Moosewood cookbook is, it's a classic vegetarian cookbook based on food from the famous restaurant in Ithaca, New York.  Unlike some of the recipes I share, this one is a bit time consuming.  There are lots of things to chop up and making real polenta is a bit time consuming because you do have to attend to it the whole time it's cooking.  BUT, you should give it a try.  It's also worth noting that a nice crusty bread also goes well with this meal.

Ingredients:

For the Polenta:
1 cups corn meal (yellow)
1 cup cold water
1 tsp. salt
3 1/2-4 cups boiling water
1 packed cup grated cheddar
grated parmesan to taste

For the Ratatouille:
1 medium onion, chopped
2 medium bell peppers, cubed
2 small, or 1 medium, zucchini or yellow squash, cubed
1 eggplant, cubed
4 cloves crushed garlic
2 medium tomatoes, in chunks
1 bay leaf
1 tsp. each: basil, marjoram
1/2 tsp. oregano
dash of ground rosemary
3 Tbs. burgundy (or any red wine of your choice)
1/2 cup tomato juice
2 Tbs. tomato paste
2 tsp. salt 
black pepper to taste
1/4 cup olive oil

Instructions:

The tricky part here is managing the polenta and sauteing the ratatouille to be finished at the same time!  I have included the order in which I have successfully completed this, but it was a little stressful at the end.  You could always make the ratatouille and then just leave it covered while you make to polenta.  In my experience the fresher the polenta, the better!

Heat olive oil in large, heavy cooking pot over medium heat. Crush the garlic into the oil.  Add the bay leaf and onion, salt lightly and sauté until onion begins to turn transparent.  Next, add the eggplant, wine, tomato juice and herbs. Stir to mix well, then cover and simmer 10 minutes over low heat.

While this is simmering, start the polenta by combining the corn meal, cold water, salt and mix into a uniform paste.  Put the water for the polenta in a large saucepan and put it over high heat.

When eggplant is tender enough to be easily pricked by a fork, add zucchini and peppers, cover and simmer 10 minutes.

While this is simmering add the corn meal to the boiling water, then lower the heat and mix fairly constantly with a whisk.  Continue whisking for 10-12 minutes until it becomes the consistency of thick breakfast cereal.  Mix in the cheese, and then it's ready.

Finish off the ratatouille by adding the pepper, tomatoes and tomato paste. Mix well. Continue to stew for 5 minutes until all vegetables are tender. 

Serve the veggies over the polenta and enjoy!  

By Jess Kehoe

This is a yummy bean and pasta salad with a deliciously creamy dressing!  This was a hit in my house, and a great meal with easy, minimal cooking, and as a bonus, great for lunch leftovers.  This is a vegan recipe full of flavor, and avocado is the secret ingredient in the dressing that gives it a great creaminess.  You can also make this salad with mixed salad greens instead of pasta for something a little lighter, or gluten free.  

Ingredients:

1/2 cup thinly sliced red onion
1 ripe avocado, pitted and roughly chopped
1/4 cup cilantro 
1/4 cup lime juice
2 tablespoons extra-virgin olive oil
1 clove of garlic
1/2 teaspoon salt
1 lb pasta
1 pint grape tomatoes, cut in half
1 green pepper, cut into bite sized pieces  (I also used 1/2 red pepper in addition for nice color!)
1 15 ounce can black beans
1 15 ounce can sweet corn

Instructions:

Cook the pasta as directed and while this is going you can make the dressing.  Combine the avocado, cilantro, lime juice, oil, garlic and salt in a mini food processor, I used an inversion blender, and process until smooth and creamy.  Drain the pasta and place it in a large bowl.  Add the remaining ingredients and toss to coat with the dressing.

Enjoy!
​

It's fall, it's Montana, it's time many start their push to "fill the freezers".  A couple of our PT's here at Alpine are big hunting enthusiasts and look forward to the yearly trek into the backcountry.  In fact, Colter Brown, DPT from our South office, is currently somewhere in Wyoming scrambling around the high country looking for big horn sheep.  Fortunately, before he skipped outta town he graciously put together some thoughts and exercises that would be helpful preparing for safely getting out in the woods, and bringing home enough game to fill the freezer.  
​

1. Start now, don't wait any longer to begin training.
2. Working unilateral (PT speak for single leg) loading exercises (step-ups, lunges, single leg balance, single leg RDL, etc.) will be better than traditional squats, deadlifts, etc.
3. Do some heavy pack training, don't avoid this. Start with a lighter load and build the load as the season nears.
4. Get a good quality backpack and train with that pack.
5. Build and work on mental toughness. The difference with backcountry hunting relative to most sports is the multi-day demands potentially followed by a heavy pack out. This will be difficult, get ready.

Here are some exercises that Colter suggests for prepping your body for a backcountry hikes and hunts.  If you find you need some more guidance, or are having trouble with them due to joint(s) pain, give Alpine PT a call.  Any of our therapists can help you work on a fitness program specific to backcountry hunting or rehabilitating after a weekend warrior injury.

By Jess Kehoe

Real fresh tomatoes are so amazing, it makes me wonder why I ever even by a tomato from the grocery store in December!  Combining them with crusty bread, basil and cucumbers is such a great combo.  I would like to thank a friend for sharing this recipe with me, and since it was so delicious and easy, I had to share it with all of you as well. 

​Enjoy! 

Ingredients:
​1 clove of garlic, diced 
1 loaf of 2 day old crusty bread cut into bite size pieces (if your bread is too fresh, toast it a little before mixing into the salad)
1 cup chopped tomatoes
1 cup cucumber, peeled and chopped
1/2 cup thinly sliced red onion
1 cup fresh basil, chopped
1/2 cup fresh thyme, chopped
1/4 cup olive oil
2 tablespoons balsamic vinegar

Instructions:
Combine all the ingredients into a salad bowl, toss and enjoy!

By Jess Kehoe

I don't know about you, but it has been too hot to cook these past few weeks!  Now, I'm not saying this smoothie is a great option for dinner, but it sure is refreshing in the afternoon, after a morning run, or following some yardwork in the sun.  My family is a big on smoothies.  When my kids were really little it was a great way to "sneak" lots of veggies into them, without them even knowing, and this is by far the most requested combo.  The dates are a great way to add sweetness to a smoothie without using a sweetener, but I do think a high-powered blender is best for really pulverizing them.  The avocado adds healthy fats and really adds a nice creaminess to the consistency.  For this particular version I had kale, but it's also great to use spinach.   

Ingredients:

1 cup water
1 ripe mango, peeled and pitted.  (If using frozen, 1-2 cups will work)
juice of one lime
1/2 avocado
2-3 dates, pitted
1 cup kale, hard stems removed (for spinach you can put in even more 2-3 cups)
1 cup ice cubes

Instructions:

Place all the ingredients into your blender, usually I put the ice in last, and blend on high for 30-60 seconds.

​Enjoy!

WHAT IS AQUATIC THERAPY? 
Aquatic therapy is a type of physical therapy treatment that takes place in the water. Aquatic therapy can be valuable for a variety of different patients to address specific impairments and challenges and is not limited to certain diagnoses. 

WHO IS A GOOD CANDIDATE FOR AQUATIC THERAPY?
Anyone! Aquatic therapy can be helpful when initiating an exercise program and addressing muscle strengthening, cardiovascular fitness, balance, mobility, and function. It is especially helpful for individuals with high pain levels as pool exercises decreases the amount of stress and compressive forces placed on joints by gravity as well as aiding in the ease of movement throughout the body.
 
WHY AQUATIC THERAPY IS HELPFUL?
The reason aquatic therapy is such a beneficial environment to begin exercise is due to the mechanics of the water and the effect it has on the body as you move. Here are the different ways the water can help you get moving again:

• Buoyancy: Decreases the amount of compressive forces placed on joints. Compressive forces through the joints in your body are reduced by 50% when in water up to your waist and 90% when in water up to your neck. Water helps support and assist movement allowing the body to move through improved range of motion with more ease and improving mobility. 
• Pressure: The pressure of the water can help reduce swelling, especially in the joints of the legs and feet.
• Resistance: The resistance produced as you move through the water allows for muscle activation and strengthening.
• Cardiovascular: Aerobic conditioning can often be performed in the water even when it may be too soon or too difficult to do on land.  Aqua jogging can produce cardiovascular results with less impact on your joints.
• Balance: Staying stable in the water challenges your core and balance in a safe and supported environment. 
• Warmth: A supportive, warm-water environment helps relax muscles and is sometimes the best place to start for people with pain, as it allows them to begin moving and exercising without aggravating their symptoms.

AQUATIC THERAPY AT ALPINE SOUTH:
Our location within the Peak Health and Wellness Center on Blue Mountain Road gives Alpine’s physical therapists the opportunity to work with our patients in an 82° competition sized pool with both a shallow and deep end. When needed, patients access the pool with a conveniently located patient lift chair or stairs with two railings. A large and comfortable therapeutic 105° hot pool is also available to help calm sore joints, perform stretches, and do relaxation exercises.  When you are scheduled for the aquatic therapy program, be sure to bring a bathing suit, towel, and lock with you to your session. Know that you can opt to wear a t-shirt and shorts while exercising. 

TEAM MEMBERS:
Brace Hayden, Gary Gales, Jess Kehoe, and Aspen McHugh are members of the physical therapy staff at Alpine that can assist with an aquatic therapy program. They are proficient in aquatic therapy and the transition from an aquatic environment to land-based therapy, helping clients return to normal activities and achieve their goals. Contact the team at Alpine Physical Therapy South, (406) 251-2323 or go online to schedule today! 

​

By Jess Kehoe

It's July and even though we've had pretty mild weather so far, July can get hot.  And when it's hot I'm not interested in doing any cooking that heats up my kitchen!  Summer is also when we have more access to fresh, local veggies, my family has a share with Garden City Harvest, so we have more greens than we know what to do with right now.  A trip to the farmers market and you easily have a full salad to be made.  When I make salad for dinner, I really like to load it up, to make it feel like a full meal.  I add whatever veggies I have on hand, often steaming up some broccoli or green beans for added interest.  I also like to include a protein.  These day's I like to avoid the pricy meat isle and go for a can of beans and a hard boiled egg, maybe some seeds or nuts as well.  As for dressing, sure the dressing isle has so many choices, but really a simple vinaigrette is so easy to make at home, you should try it!  It's a great back up for when all your store bought dressings are nearly empty (this seems to happen to me a lot!).   I've found, even though my kids are pretty flexible eaters, salad for dinner usually gathers some moans.  But croutons save it for them!  We buy the big bag at Costco, because making croutons is NOT that easy, and not last minute enough, but that Costco bag is perfect.

In general I like to toss my salad with the dressing, but I also have a great hack for your lunch salad, because soggy day old salad is not that enticing.  Grab a pint size mason jar, put your dressing in first, add some veggies that won't get soggy sitting overnight in the dressing, then add the lettuce.  Leave it in the fridge overnight, ready to grab for the next day.  At work, or home, when you dump it into a nice big bowl it's still fresh. 

​Enjoy!

Ingredients:

For the salad, toss together the following in a large bowl (feel free to choose your own veggie adventure, this is just what I had on this day in the fridge!)

4-6 cups of lettuce, cut into bitesize pieces (any kind will work, this one is iceberg and romaine combo)
Two small carrots, sliced
Two radishes, sliced
1/2 kohlrabi, sliced
One small head of broccoli, cut into bite sized pieces and steamed for 3 minutes
One sliced red pepper
Two sliced mushrooms
4 hard boiled eggs
1 can garbanzo beans
Two handfuls of pre-made croutons


For the vinaigrette:  Place the ingredients in a jar and shake vigorously
​
3 tablespoons red wine vinegar
3/4 cup extra-virgin olive oil
1 garlic clove, minced
1 teaspoon Dijon mustard
Salt and pepper to taste

On the road this summer?  Car accidents happen a lot in the US, so if you have just experienced one, you've joined the multitude of unfortunate others with a new wreck in their hands. According to the National Highway Traffic Safety Administration, car accidents happen at frequent intervals estimated at one every 60 seconds. That equates to about 17 thousand car accidents each day and 5.25 million accidents across the nation on a yearly basis. Whoa!!  That’s a lot. At Alpine PT we see many clients who have recently been in a car accident and it’s not uncommon to have some lingering aches and pains from such an event.  We asked our PT’s to weigh in on some helpful advice if you find yourself a new member of this club this summer.
 
Brace Hayden reminds people of these statistics, as they're quite common and can upset our lives in many ways. He understands that there are usually hassles with body damage to your car, haggling with insurance companies, the police and the other driver, and the aftermath of contusions and whiplash-related injuries. His advice to start is to “take a deep breath, harness your inner-calm, as this will get better...but I get it that at the present time it wasn't fun being in the wrong place at the wrong time.”
 
If you notice some aches and pains coming on after a car accident, Dennis McCrea recommends that you get a referral to a Physical Therapist, of course.  “Then I would recommend they use heat or ice, perform gentle movements of their neck, brief rest breaks and gentle massage until they see the PT and avoid a lot of looking down as with reading and looking at their phone.”
 
Gentle movements immediately following a car accident and for the next few days is a common recommendation from our PT’s.  Angela Listug-Vap has this advice “Know that delayed soreness is totally expected and normal. You might feel stiff with movement but don't be afraid to do light movement, walking and gentle rotations in the neck and back - it'll actually help even if it's sore in the moment.”  Matt Schweitzer concurs, advising “gentle walking or gentle activity to keep moving help the blood circulate through the body.  Listen to your body to not over do the intensity or duration.”
 
Another piece of advice from Angela includes drinking extra water and icing sore areas.  Water is an essential component of healing and an easy thing to try, and unfortunately many of us are already chronically dehydrated.   Ice can be a miracle pain reliever without harsh side effects.  All you need is 15 to 20 minutes, a few times per day.
 
Advice from Leah Versteegen is along the same lines, reminding us how common it is to be sore, but that gentle movement is safe and helpful. “Onset of pain a few days after a car accident is pretty common. This delayed onset muscle soreness is similar to how your body may feel sore 2-3 days after running a marathon for the first time or that first day of ski season when your body isn't quite in shape. Your tissues are not prepared for the impact of a car accident and let you know by creating that feeling of stiffness and soreness for days and even weeks after. Getting in to see a PT for an assessment and some advice on how to best help your body recover is essential during this time period. Everyone's body is different, and every accident is a little different so making sure that your recovery plan is catered to your specific needs is important. Your body will heal and with the guidance provided by your PT, you can get back to doing what you love most just a little faster.”
 
Bottom line is that as long as you have no severe injuries, be ready for some delayed soreness.  Don’t hesitate to seek referral to PT, stay hydrated and get some gentle exercise and movement going.  You can call us at (406) 251-2323 to get scheduled and safe driving this summer!