It's the middle of February, days are getting longer and it's about to be light when we get home from work.  When that happens, all of the sudden I see people out running - everywhere!  It's also about 20 weeks from the Missoula Marathon and 1/2 Marathon, the ideal time to begin your training routine.  At Alpine PT we love running and the people who run.  Here at Alpine PT, many of us are runners, at some level, and we all think running is a great way to move your body and stride around this beautiful place we live.  We take a stance against the common refrain heard a lot, “running will wreck your knees,”  when in fact there is expanding evidence that runners have more healthy cartilage in their knees than non-runners.  Therefore,  at Alpine we believe that almost anyone can take up this age-old human form of recreation.  We've collected a little advice from some of our PTs and their suggestions to be a successful runner.

Jess Kehoe advises the old saying, “slow and steady wins the race”!  When trying to build up miles, take your time.  A good rule of thumb is not to increase more than 10% per week.  But also listen to your body.  And, “if you are getting up there in the age decades (like me who just headed closer to 50 than 40 😬) recovery starts to play a more important role”.  So getting good nutrition and rest are just as important as the miles.  

Dennis McCrea, a seasoned and wise runner beyond any doubt, with several marathons, including the Boston under his belt, gives this advice: "Get into a consistent daily core strengthening and stretching routine NOW to prevent injuries in the future."  He also encourages a training plan, both for new and experienced runners.   "For those who have not run a lot and for whatever reason have decided to run a 1/2 or full marathon I would recommend signing up for the Run Wild Missoula running class. It is geared for all types of runners but especially those who have not gone through that sort of training. It gives them guidance, people to run with at a similar pace, and provides lots of great running tips."

Angela Listug-Vap is in agreement on training and recalls that "after years of treating 'new to marathon' runners, I'd say the most common training errors I saw were: 1) ramping up too fast, and 2) no cross training of any kind, just running. I found once people started cross training for more lateral and cross body movements, plus core and hip strength they did great."  She also shared a great "race day" consideration: "when you travel to a marathon you're tempted to get there early and spend a day or two walking around to check out the place.  Don't do it, limit your steps the day before a race - your body will thank you."

Brace Hayden reminds us that the knowledgeable PT's at Alpine can also help you make a successful plan.  "I advise patients that are looking at training for longer mileage races to dial in a solid running program. Giving their current running program a review is helpful and then balancing it out. I try to make sure they have a dedicated dynamic warm-up at the beginning of each run and make time for some sort of short post-run stretch/mobility routine. Lastly, I work with the runner on customizing some cross training and a comprehensive strength routine to avoid injuries that often crop up with high-mileage runs."​

So here's to the last few weeks of winter. Maybe you're not quite ready to trade your skis out for your running shoes, but soon the sun, trails and dry sidewalks will lure you out there.  As always, keep Alpine PT on your speed dial (406)251-2323, so if problems do arise, our expert PT's can help you take care of them quickly.

By Jess Kehoe

I am not a food photographer, or a food stylist, or a trained chef, these are the facts.  The photo of this meal on the Food and Wine website looks nothing like this!  The chicken in their photo is perfectly browned.  I don't know how they accomplished that, I even cooked them longer than they recommended, to "brown" them.  Maybe mine are so drab because my chicken thighs were skinless?  Maybe you could try thighs with skins and they would brown better without getting stuck to the pot (which mine did terribly).  But seriously, you should overlook the photo and cook this dish.  Its pretty darn easy, and very tasty!  This recipe fed my family of 4, my two parents and we still had two lunches left over. I love when dinner gives me a wholesome lunch for the next day. ​

Ingredients

2 tablespoons olive oil
8 chicken thighs
2 teaspoons salt
1/2 teaspoon black pepper
1 large onion, cut into thin slices
2 cloves garlic, minced
1 1/2 teaspoons ground coriander
1 1/2 teaspoons ground cumin
1 1/2 cups long-grain rice
1  14 oz can of unsweetened coconut milk
1 3/4 cups water, and maybe little more at the end
1 lb zucchini, cut into 1/4 inch dice
1 tablespoon lemon juice
1/3 cup cilantro, chopped (optional)

Instructions

In a deep frying pan or a Dutch oven heat the cooking oil over moderately high heat.  Sprinkle the chicken with 1/2 teaspoon of the salt and 1/4 teaspoon of pepper.  Place the chicken in the pot and brown well on both sides, about 8 minutes.  Remove the chicken, set aside and reduce the heat to moderately low.

Add the onion and cook until soft, stirring occasionally, about 5 minutes.  Add in the garlic and cook for one minute until fragrant.  Stir in the coriander, cumin, rice and the remaining 1 1/2 teaspoons of salt and the 1/4 teaspoon of pepper.  Stir and cook for about a minute to coat the rice with the spices.

Then stir in the coconut milk and the water.  Return the chicken to the pot and bring this to a simmer.  Cover and simmer, stirring occasionally until the rice is almost done, about 20 minutes.  You may find you want to add 1/4-1/2 cup extra water towards the end if it is looking too dry.  Stir in the zucchini, cover and cook for about 8 more minutes, until the zucchini is just tender.  

Stir in the lemon juice and the cilantro (if desired) and serve.

​Enjoy!

By Jess Kehoe, DPT

, Lentil soup is a great winter comfort food, and lentils are such a great source of protein.  My usual go to lentil soup is a blended version, but I saw this on Food and Wine and thought I should give it a try.  What a good choice!  The flavors of this soup really turn out wonderful.  It also makes a huge amount and we ate two dinners and several lunches from the one pot.  I also think it would be a great one to freeze for a future meal, or if you are doing a lot of meal prepping.  One note, this calls for three full onions, which seemed like way to many, and so I only used two.  That still seemed quite excessive but in the end was probably part of what made it so delicious!  

Ingredients
1 lb French green lentils
1/4 cup olive oil
3 large onions, chopped (I only used 2) 
3 cloves garlic, minced
2 large leeks, white and tender green parts chopped
1 tablespoon salt
1 1/2 teaspoon black pepper
1 tablespoon chopped fresh thyme, or 1 teaspoon dried
1 teaspoon ground cumin
8 celery ribs, cut into 1/2 inch dice
6 medium carrots, cut into 1/2 inch dice
3 quarts chicken broth or vegetable broth
1/4 cup tomato paste
2 tablespoons dry red wine or red wine vinegar
Freshly grated Parmesan Cheese for serving

Instructions
In a large heatproof bowl, cover the lentils with boiling water and let stand for 15 minutes.  Drain and then set aside.

While the lentils are soaking, heat the olive oil in a large soup pot on medium heat.  Add the onions, leeks, 1 tablespoon of salt, 1 1/2 teaspoons of pepper, thyme and cumin.  Cook stirring occasionally until tender, about 20 minutes.

Add in the celery and carrots, cook until they begin to soften, about 10 minutes.  Add the stock, tomato paste and the lentils, increase the heat to high and bring to a boil.  Then lower the heat to moderate and simmer uncovered, until the lentils are tender, about an hour.  You will want to stir this occasionally while it is cooking.

Stir in the red wine and season to taste with salt and pepper.  Serve hot with a sprinkle of Parmesan.

​Enjoy!

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!