“I’m fine.”
How often do we hear this response? It’s second nature really—an automatic reply to keep things moving and progressing forward. We see it on the big screen constantly, reiterating how common and ok it is to just press on to win the big game or evoke some false sense of bravery or strength in an emotional scene. But what if the bigger act of courage is to admit that something might not be fine? Peak Performance Physical Therapy has seen the full gamut of human tolerance, offering sports medicine, orthopedics, vestibular and concussion therapy in addition to women’s health, focusing on pelvis floor issues, breast cancer and lymphedema rehabilitation since 1995.
Headed by Jill Olson, PT—a 5th generation Missoulian—Peak Performance Physical Therapy has been deeply involved in the evolution of concussion recognition and rehabilitation among many other injuries that go misidentified, mismanaged, or minimized. Industry standards beckoned change in how they manage potential brain injuries here in Missoula but it wasn’t until a local tragedy struck our community that new implications were put in place.
“It was on Mother’s Day, 2010, he was playing a football scrimmage for Eastern Oregon and his parents were there watching the game. In the fourth quarter, he took a knee to the head and walked off the field and was disoriented and then collapsed,” said Jill. “They life-flighted him to Boise and he sadly passed away with a fatal brain injury a few days later.” She’s telling the story of Dylan Steigers—the young man whose namesake is the Dylan Steigers Concussion Project, a non-profit which encourages education, testing, and protection for these types of injuries. The project originally served as a resource for coaches, parents, and athletes to learn more about concussions and traumatic brain injuries. Since 2010, the project has raised over $250,000 to advance knowledge of concussion identification, management, testing, and awareness. The project has expanded to serve concussed individuals throughout Montana.
“He had multiple signs of concussions in high school,” said Jill. “As the concussions most likely progressed, he struggled a lot more with school, with classes, with behaviors—a lot of behavioral changes that now looking back, his parents are pretty sure there were probably more concussions there that hadn’t been fully identified and handled as we know to handle them now.” Today, Peak Performance Physical Therapy & Sports Medicine utilizes specially trained physical therapists to assess the vestibular system, oculomotor system, balance, dynamic visual acuity and a neurocognitive screen. These assessments often serve as a caveat to identify previous concussions and/or weakness of those systems leading to a higher chance of sustaining additional concussions. “Over 65% of concussions have vestibular involvement and 95% of concussions involve the ocular motor system. Big percentages,” said Jill. We’ve gone beyond the concussion baseline program testing now to involve the professional assessments of the vestibular system and the oculomotor system, and the autonomic nervous system."
It’s a complex web of bodily systems that the staff at Peak Performance Physical Therapy & Sports Medicine has to navigate to diagnose and treat any individual with a suspected concussion. There is cognitive fatigue which relates to memory, attention, and concentration, the vestibular system which relates to our equilibrium, the oculomotor system and eye tracking, neck injuries, migraine sequela, autonomic nervous system—a biggie that houses your breathing, exercise tolerance, anxiety, heart rate, and blood pressure—and disordered sleep, moods and emotions. Among these, POTS syndrome—postural orthostatic tachycardia syndrome. “It really takes specially trained professionals to identity all of those systems, what triggers those systems, and drives the symptoms,” said Jill. (See side bar for symptoms to look out for!) “So with our concussion assessments, we need to assess all of these systems, see what’s been impacted, and then come up with very specific treatments for each of those areas that have been impacted.” These improvements with deciphering if someone has had a concussion has also led to big state changes like the Dylan Steigers’ Protection of Youth Athletes Act. Peak Performance has been able to operate at the level they desire with help from the Community Health Alliance (previously known as the Foundation for Community Health) by receiving two grants to purchase the RightEye Neurovision software and finance advanced concussion education for the staff.
So why is Peak Performance Physical Therapy & Sports Medicine so invested in Missoula? Just ask the woman at the heart of it all: Jill Olsen. “I was raised by the most amazing tapestry of my Missoula village people. My parents always taught me to give more than you receive, and to give back to Missoula.” She went to Hellgate High School and remembered her dad encouraging her to choose a profession. Teaching, accounting, and physical therapy were the top contenders until she witnessed firsthand the work that was done and the lives that were touched through Key Club and Kiwanis Club. Her outreach as a member included supporting students with disabilities. “I was just so moved by working with those students with disabilities and seeing other physical therapists work with them. What we did there really, I think, lit the fire for me to want to pursue physical therapy.”
She later married a physical therapist—Barry Olson, formerly the director of rehabilitation at Community Medical Center. “He was really instrumental in launching the Ronald McDonald House in Missoula.” That venture has made a lasting impression on the Missoula community and served so many families along the way.
The efforts of her personal and professional lives are tightly wound, making her job not just a job but a passionate career which has been led by each chapter of her life. “As the business exploded, I was traveling all over Western Montana, servicing part-time contracts for part-time coverage when I realized my passions at that time really were orthopedics and sports medicine and working with women with breast cancer,” said Jill. “And then we took on a whole line of breast prostheses and bras, and with my orthopedic knowledge I was able to bring a good treatment approach to all the shoulder involvement and upper trunk involvement following mastectomies and lumpectomies and radiations. And then I added a lymphedema certification.” From there, as her three kids grew and got involved in ballet and soccer, she became specialized in dance medicine. “I was very passionate about feet and orthotics so then I took on a whole line of ballet pointe shoes and opened up a dance shop, selling ballet pointe shoes, because we could get a real customized fit and I became well-versed in all the orthopedic injuries and mal-alignment injuries that dancers have.” She was also the soccer mom on the sidelines, completely equipped with braces and tape and treatment options of every variety.
Of course, her family and passion led life has also involved other groups in Missoula like the Brain Injury Alliance of Montana (BIAMT). “We’ve done a lot of cosponsoring and supporting of each other. The BIAMT generously sponsored three of our physical therapists to attain their brain injury specialist certifications (CBIS),” said Jill. Her biggest success though is a humble one. “I know all of us is smarter than one of us,” said Jill. “Three of the strongest traits I look for in hiring is employees who are humble, hungry, and smart. And so we bring our strengths to the table for the good of the patient, and my job is to identify their strengths and turn them loose…Medicine is an art and a science, and corporate medicine and productivity demands have stripped away the art of medicine. At Peak Performance you’ll find the art of medicine thriving.”
"At Peak Performance you’ll find the art of medicine thriving.”
SIDE BAR #1 (for Flex Page 15)
Fast facts from UPMC—a world-renowned health care provider and insurer—regarding concussions:
- Between 1.7 and 3 million sports- and recreation-related concussions happen each year. Around 300,000 of those are from football
- Five in 10 concussions go unreported or undetected
- Two in 10 high school athletes who play contact sports—including soccer and lacrosse— will get a concussion this year
- Girls' soccer sees the second most concussions of all high school sports, while girls' basketball sees the 3rd most.
Symptoms of concussion include:
- Dizziness
- Imbalance
- Nausea and/or vomiting
- Balance problems
- Sensitivity to noise
- Sensitivity to light
- Blurred vision
- Headache
- Low energy
- Unequal pupils
- Sleeping more or less than usual
- Difficulty remembering
- Confusion
- Inability to concentrate
- Mental fogginess
- Loss of focus
- Easily angered or upset
- Feeling nervous or anxious
- Feelings of sadness
- Crying more than usual
- Lack of interest in usual activities
Side Bar #2:
Peak Performance Physical Therapy
1940 Harve Avenue, Suite 2
406.542.0808