Summertime Fun

"Of all the paths you take in life, make sure a few of them are dirt." - John 

Granite Sports Medicine's Alison Shannon-Lier and Jennifer Gauthier went mountain bike riding recently, Jennifer says, "Movement is our medicine. Get outside this summer!"

Reflecting on the ride, Alison says, "It makes me think about how blessed I am to work with amazing, smart coworkers who also love getting out and playing hard, pushing me both in the work place and outdoors!"

Share photos of yourself getting outside this summer, we love to see our active community in action! Email buzzmemedia@gmail.com

#Montanamoment #ActiveCommunity #getoutside


Granite Sports Medicine Celebrates 5 Years

Granite Sports MedicineCan you believe Granite Sports Medicine (GSM) is 5 years old? GSM is proud to the celebrate benchmarks, achievements, growth and success stories from the active community we’ve served in our first 5 years over the next month. Thank you Park County! Follow us on Facebook or stop by the clinic to see how you can participate in our Granite Sports Medicineanniversary month and win cool stuff!

To celebrate GSM’s 5 years of Success Stories from our active community, we are having lots of drawings for fun stuff. To enter, stop by GSM to fill out our quick “Say Something Nice” form, and we’ll enter you into a drawing for stainless steel GSM water bottles. We have a bunch so increase your odds by filling out a bunch!

If you aren’t able to stop by, share your testimonial online at http://www.granitesportsmedicine.com/livingston-physical-therapy-testimonials/ or post a phots of you and a GSM logo doing something cool on our facebook page to be included in drawings for deluxe GSM soft-side coolers!  Granite Sports Medicine

At the end of the month, we will pick our 5 favorite “Say Something Nice” testimonials and each will win a cooler. The end of our 5-year anniversary month will culminate with a Cinco Tailgate party in GSM parking lot, 5/5/17 from 4 – 6 pm. We’ll have a full taco bar and more swag giveaways, so stop by and help us celebrate.  

GSM’s 5 Pillars: Granite Sports Medicine
As part of a Prospera workshop on business startup many years ago, we created 5 Pillars that we felt were integral to the success of our business. It is interesting how these have summarized our culture at GSM and continue to be relevant.

  1. Strong community presence
  2. Client retention
  3. Positive work environment
  4. Efficient systems
  5. Fiscal responsibility

These pillars lead to a customer experience that makes a lasting impression, “The clinic, including the reception, is efficient, very professional and makes the patient more knowledgeable. The clinic is the most dedicated that has ever treated me. The patient is made to feel comfortable and cared for,” says a client and another adds, “Entering Granite Sports Medicine is a happy experience! There is an infectious enthusiasm that helps patients want to get better.”

GSM’s 5 Year Benchmarks:Granite Sports Medicine

  1. Remember the Main St Carwash?  We sure do, and we remember all the pigeons. Yuck. It was important to us to repurpose an old structure and contribute to cleaning up Livingston’s Main Street. Amazing that Randy Cook had the vision and the skills to remodel the old car wash into the extensive physical therapy hub GSM is today.  
  2. Client Retention/Customer Service: you made suggestions and we implemented them. No unnecessary paperwork at check in, virtually paperless clinic, clear explanations of client’s insurance benefits, and making sure our customers understand the process. Quote: “The front office staff is always welcoming, fun and positive. They are great with patients, explaining costs and insurance thoroughly, and juggling appointments around work schedules.”  
  3. Winning the 2016 Montana Women’s Business Center’s Start-Up of the Granite Sports Medicine Prospera Womens Business Award Bozeman MontanaYear at Prospera Business Network’s annual Business Excellence Awards for exceptional contributions to the region's business community. “Prospera’s support has been a huge part of our success since opening our doors in 2012. Six years ago, I went into the Prospera office thinking, ‘Maybe I should open a physical therapy clinic,’ and here we are now with a beautiful 4,500 square foot facility and 9 employees. It’s been an incredible growth process and Prospera held my hand throughout; from developing a business plan, to formulating financial projections, securing gap financing, to building Human Resource manuals, and how to use social media. Prospera has been integral to GSM's success and I am so honored by this recognition. I feel like I went in as a pupil and recently graduated from their fantastic ‘Business Start-up School’,” says Darcy Cook.
  4. Hosting a sold-out first continuing education class in Level 1 KinetaCore Granite Sports Medicine KinetaCore Dry Needling Dry Needling. Part of our big vision was to be able to bring quality continuing education classes to Montana. Not only does it keep our PTs up to date but it elevates our entire profession. Our first class was a huge success and there will be more to come. 
  5. Incredible growth. We can’t thank our community enough for the support over the past 5 years. We are fortunate to have experienced incredible grow and recruit amazing staff members, for that we thank you, our supportive and active community.

GSM’s 5 Physical TherapistsGranite Sports Medicine staff

GSM’s mission is to enhance health and wellness through innovative, evidence-based Physical Therapy interventions. It has been our goal to be the most current, progression clinic in Southwest Montana. Our physical therapists are passionate about the profession and pursue the highest level of evidenced-based continuing education and certifications, offering clinical excellence.
We are proud to have all of our staff certified in Dry Needling as well as the following specialties:

  1. Founder Darcy Cook, MSPT; headaches and facial pain, and bonus: the physical therapist for the U.S. Snowboarding Team.
  2. Gary Miller, MS, PT, CPed; Orthotic Fabrication.
  3. Jennifer Gauthier, DPT; Vestibular Rehabilitation.
  4. Alison Shannon-Lier, DPT; Pelvic Floor Rehab.
  5. Max Bartlett, DPT; Certified Strength and Conditioning Specialist and Sports Physical Therapy.

A client says of GSM founder Darcy Cook, “It is evident she stays informed with the latest in physical therapy news and advances in technology regarding the profession. Darcy is organized and thoughtful about her individualized treatment protocols. Thanks to her and to the staff at Granite Sports Medicine, I left each visit feeling positive about my recovery. We are lucky to be able to receive such care in the state of Montana.”

GSM’s 5 Community Actions:Granite Sports Medicine Livingston Recreation Basketball

  1. GSM sponsors various teams throughout the years, including Livingston Parks and Recreation youth basketball team (photo) with GSM’s Alison Shannon-Lier as one of the coaches.
  2. GSM sponsors and joins Western Sustainability Exchange’s Farmer’s Market.  You may remember the awesome beer cozies we give away....
  3. GSM’s Gary Miller does free foot screens for the Park High track team.
  4. GSM’s Darcy Cook does physical therapy presentations at Park High’s Trades Day (back by popular demand!)
  5. GSM offers free 20-minute sports injury assessment to Park High athletes performed by Jennifer Gauthier and Max BartlettGranite Sports Medicine

Thanks for all the support, enthusiasm and for inspiring us with your recovery GSM clients and community! Here’s to many more years of healing and actively enjoying our wonderful region.

Granite Sports Medicine is located at 315 S Main Street in Livingston, phone (406) 222-4682. Sign up for our informative newsletter at http://www.granitesportsmedicine.com/livingston-physical-therapy-newsletter/, share your testimonial online at http://www.granitesportsmedicine.com/livingston-physical-therapy-testimonials/  and follow us on social media at https://www.facebook.com/granitesportsmedicine


Rousing Recent Pelvic Floor Roundtable

Pelvic Floor Roundtable Granite Sports MedicineGranite Sports Medicine recently held a roundtable discussion about Pelvic Floor Physical Therapy. Alison Shannon-Lier PT, DPT introduced information about what pelvic floor therapy is and how it can be beneficial to many patients, both men and women. There is a need for increased knowledge about this progressive therapy. The general opinion of those in attendance was that pelvic floor therapy is of great interest.

One local physician expressed that she is a huge advocate for this type of therapy. She feels that it should be included in preventative care, and utilized after childbirth and hysterectomy surgery. In France, it is routine to have ten to twenty sessions of pelvic floor therapy after each birth. Dr. Shannon-Lier pointed out that there are other medical conditions this therapy can treat including abdominal surgery, pelvic surgery, hernia repair, back surgery, C-section, chronic low back pain and pelvic pain. Dr. Pinango, an OB physician at Livingston HealthCare, felt that earlier post-partum visits would be a good practice as it would help patients be prepared for the first six weeks of post-partum health.Pelvic Floor Roundtable Granite Sports Medicine

The topic of men and pelvic floor therapy was brought up. The U.S. Military sees quite a few male patients for pelvic floor chronic pain therapy. Anyone doing heavy lifting, straining or physical work should be aware of this therapy and what it can do for them.

Many great ideas and opinions were given by the community members who came. Dr. Shannon-Lier said, “Everyone’s opinions and questions were helpful for what the community needs.” Positive feedback from current patients and amazing testimonials of success were given to the group. One patient who was unable to attend sent a moving letter telling of her journey of misdiagnosis, decreased quality of life, and prescribed pain medication. She shared her success following treatment with Dr. Shannon-Lier stating, “I am no longer taking pain medication or sleeping with a heating pad.” 

Another takeaway from the event was that people should know that others have symptoms and pelvic floor issues; you are not alone. New patients have booked appointments and there have been many requests for informational packets.

Learn more about at Dr. Shannon-Lier, Pelvic Floor Therapy, and our recent pelvic floor blogs here and here. Make an appointment online at  http://www.granitesportsmedicine.com/livingston-physical-therapy-contact/ or phone 406-222-4682. Thanks to everyone who participated in this successful roundtable!


Pelvic Floor Roundtable Discussion 3/30/17

You are invited to a roundtable discussion about Pelvic Floor Therapy on Thursday, March 30th from 6 to 7 pm at Granite Sports Medicine, 315 S Main Street in Livingston. Granite Sports Medicine’s Pelvic Floor Physical Therapist Dr. Alison Shannon Lier, who was recently certified through the Pelvic Floor Rehabilitation Institute Hermann & Wallace and has been a practicing physical therapist for eight years, wants to share her new expertise at a roundtable discussion. Lier has been interested in Pelvic Floor Physical Therapy for 5yrs and is new to Park County, she's seeking input and opinion on how best to get the word out about the emerging field of Pelvic Floor Physical Therapy.

Come enjoy light snacks and beverages during a short presentation and share your thoughts with us. Your voice matters!

Unfamiliar with Pelvic Floor Physical Therapy? It’s the evaluation and treatment of pelvic floor dysfunction, caused by a wide range of impairments within the muscles of our pelvis. The pelvic floor muscles make up a sling within your pelvis and help support abdominal and pelvic organs, as well as help control bladder and bowel function, and sexual activity. 1 in 5 Americans – men, women, and children – suffer from pelvic floor dysfunction that goes unidentified or undiagnosed. Lier herself suffered from incontinence during middle school and high school and knows personally how frustrating and embarrassing it is. She’s also seen firsthand and with patients how pelvic floor therapy can more than improve someone’s symptoms. It can improve their quality of life as well.

To learn more join us March 30th and visit  http://www.granitesportsmedicine.com/livingston-physical-therapy-pelvic-floor-roundtable-discussion-3-30-17/

Phone 406.222.4682 with questions.


Pelvic Floor Therapy 101

Granite Sports Medicine now has a Certified Pelvic Floor Physical Therapist on Pelvic Floor Physical Therapystaff, Alison Shannon-Lier, who also holds a Doctorate in Physical Therapy. Learn more about how Dr. Shannon-Lier became interested in this field here.

  • What’s a pelvic floor? It’s three layers of muscles at the base of our pelvis, directly related to bowel, bladder and sexual function.
  • What does it do? A healthy pelvic floor prevents leakage of urine, feces or gas and supports satisfying sexual experiences as well as supporting our internal organs.
  • What is pelvic floor dysfunction? These muscles, like any group of muscles, can be tight, weak, or dysfunctional, and cause pain.
  • Is this rare? No, one in five Americans suffer from pelvic floor dysfunction that goes unidentified or undiagnosed.
  • What does a Certified Pelvic Floor Physical Therapist (PFPT) do? They’ve had specialized internal pelvic floor training, in addition to their physical therapy education, and assess the body as a whole; looking at posture, core and leg strength, pelvic alignment, as well as the internal pelvic floor muscles and how they affect your daily life.
  • Who benefits from Pelvic Floor Physical Therapy? Men, women and children who’ve been diagnosed with a pelvic floor dysfunction or suffer from chronic back or pelvic pain (see list below). This therapy is less invasive than other treatments, such as surgery or medication, and often addresses chronic conditions that haven’t responded to other treatment. The PFPT can also educate patients on other contributing factors, such as dietary choices and emotional stress.

What to expect on the first visit? A thorough, but discrete and completely private, history will be taken by the PFPT, who also has a doctorate in Physical Therapy. The PFPT is trained in gender-specific external and internal physical examination of muscle length, skin integrity, postural alignment, muscle strength and causes of pain.

What to expect on follow-up visits? Frequency of visits will depend on the patient’s presentation and diagnosis, but usually, it will be once or twice a week initially. During treatment, the therapist will do both internal and external manual work to improve pain, muscle length, relieve any trigger points, and begin an appropriate strengthening program.

Frequently treated diagnoses: 

  • Pelvic pain
  • Tailbone pain
  • Sacral iliac (SI) joint pain
  • Low back pain
  • Leg or “sciatic like” pain
  • Vulvodynia
  • Interstitial Cystitis
  • Irritable bowel syndrome
  • Urinary incontinence (urgency, frequency, nocturia and stress)
  • Chronic pelvic pain
  • Endometriosis
  • Sexual dysfunction
  • Vaginismus

Contact us to make an appointment with Dr. AlisonShannon-Lier online here.


Why pelvic floor physical therapy?

AlisonHi, I’m Alison Shannon-Lier, a physical therapist at Granite Sports Medicine with a Doctorate in Physical Therapy, Bachelors in Rehab Science, and in 2016 I finished my Level 1 Certification in Pelvic Floor Physical Therapy. When I started talking about becoming a Pelvic Floor Physical Therapist a few years ago, people had questions. What’s a pelvic floor? It’s three layers of muscles at the base of our pelvis, directly related to bowel, bladder and sexual function. Like any group of muscles, they can be tight, weak, or dysfunctional, and cause pain. And what’s the appeal of Pelvic Floor Physical Therapy?

The simple answer is: there are thousands of Americans – 1 in 5 – who are underdiagnosed for pelvic floor dysfunction and are suffering in silence, people who need support and education and answers for their pain, embarrassment, and discomfort. Pelvic Floor Physical Therapy (PFPT) can help in many of these cases.

The more personal and longer answer: I suffered for years from stress incontinence through middle school and high school. It was embarrassing and frustrating. I was constantly worried about how I dressed, who I’d be with, and avoided situations that would lead to leaking. I didn’t know who to talk to, was too embarrassed to talk to my parents or friends, and dealt with it alone for years until college. In college I began to learn more about my pelvic floor in physical therapy school; about appropriate stretching and strengthening. I began self-treating and it helped some, but didn’t fully fix the problem.

When I became pregnant at age 25, I was managing my incontinence with an extensive training program, watching what I ate, and doing a lot of plyometrics with kegel exercises. But the problem came back full force when I was pregnant, leaving me frustrated and occasionally even having to change clothes at work. I was frustrated and annoyed but didn’t bring it up because I thought it was something I just had to deal with.

After I gave birth to my son, I was amazed to discover that my incontinence was gone, and has been for the last five years. I learned I wasn’t lacking strength, but that my pelvic floor muscles were too tight. The insufficiency was due to trigger points and muscle tightness, rather than weakness.

This could have been treated years ago if I had been less embarrassed and had the right information. That is what I want to provide to my community; I’m motivated to help men and women return to a normal life without anxiety when they laugh, want to jump on a trampoline with their kids or have sex with their partner. These are all things we should freely enjoy in our life and, with Pelvic Floor Physical Therapy, I can help diagnose and treat pelvic floor dysfunction so people can get these enjoyments back. 

Stay tuned for my next blog to learn more about pelvic floor symptoms and treatments. We’re all excited at Granite Sports Medicine to be providing education and services in the emerging specialty of Pelvic Floor Physical Therapy! Make your appointment today here.


Think PT First! What is Direct Access?

As you may have seen on the news, the AMA (American Medical Association) has made new recommendations that patients consider going to physical therapy first for back pain instead of costly Emergency Room and Medical Doctor (MD) visits. The evidence is clear that the sooner you see a physical therapist (PT) for low back pain, the faster you recover. Visiting a doctor first will be more costly, involving unnecessary imaging, injections or opoid prescriptions, and ultimately result in a referral to PT down the road.

“Direct Access” refers to the ability to come directly to a PT without seeing an MD first. All 50 states have some form of direct access and Montana has been a direct access state for approximately 25 years. Although there are a few insurance policies that still require a prescription for reimbursement, the trend is towards allowing more direct access. Click here to learn more about direct access and how to determine your insurance requirements and coverage.

The one concern some have expressed is that PTs might miss a major pathology and/or misdiagnosis the issue when seeing patients through direct access. However, there has been no data to support this claim. Physical therapy is a doctorate program and a large portion of the curriculum is geared towards differential diagnosis or determining the cause of your problem, while ruling out red flag concerns. And, when appropriate, we work with other health care providers to help determine the best path to your recovery.

The benefits of direct access are numerous. Not only does it decrease the overall cost to our health care system in fewer visits - plus reduced missed work time and eliminating unnecessary imaging and surgical costs - it is well established that the sooner people get into physical therapy the more rapid their recovery and the better their outcomes.

So give us a call at 406.222.4682 and get started! We pride ourselves in being an excellent first choice for your musculoskeletal needs. 


Winner of 2016 Mt Womenโ€™s Business Center Award

awardGranite Sports Medicine has won the 2016 Montana Women’s Business Center’s Start-Up of the Year at Prospera Business Network’s annual Business Excellence Awards. The Business Excellence Awards recognized businesses and individuals in five categories for their exceptional contributions to the region's business community. Granite Sports Medicine’s mission is to enhance health and wellness through innovative, evidence-based Physical Therapy interventions and their motto is: Physical Therapy for the active community.

Granite Sports Medicine (GSM) Founder Darcy Cook says, “Prospera’s support has been a huge part of our success since opening our doors in 2012. Six years ago, I went into the Prospera office thinking, ‘Maybe I should open a physical therapy clinic,’ and here we are now with a beautiful 4,500 square foot facility and 8 employees. It’s been an incredible growth process and Prospera held my hand throughout; from developing a business plan, to formulating financial projections, securing gap financing, to building Human Resource manuals, and how to use social media. Prospera has been integral to GSM's success and I am so honored by this recognition. I feel like I went in as a pupil and recently graduated from their fantastic ‘Business Start-up School’.”

In addition to a Master’s Degree in Physical Therapy, Cook is a Canine Rehabilitation Therapist and sees canine patients twice a week at her Black Dog Rehab clinic within Granite Sports Medicine. Learn more at http://www.granitesportsmedicine.com/livingston-physical-therapy-staff/16/Darcy-Cook-MSPT/ and www.406bdr.com


Dry Needling

What is "needling"?

Trigger Point Upper TrapeziusYou may have heard through a friend or colleague about the relatively new modality, dry needling (DN), which is also known as Functional Dry Needling or Trigger Point Dry Needling. Typically, the response is overwhelmingly positive and people report fantastic results. It is an evidenced based technique that uses a blunt monofilament needle to release "trigger points". A trigger point is a hyperirritable spot that is painful upon compression, commonly known as muscle knots. These trigger points have characteristic referral patterns, that is, when they are compressed patients consistently feel pain in a different referred area. For example, the trigger point (X) in the neck muscle (upper trapezius) has a referral pattern that causes "tension headaches" (red area).

Historically, we have released deep muscle tension through various techniques such as massage, mobilization, stretching, postural changes, and other modalities. DN is another way to mechanically release trigger points and can be thought of as a manual therapy or massage technique. Recently, the APTA specifically adopted DN into our national practice act, recognizing it as an effective treatment choice for physical therapists.

All of the physical therapists at GSM are certified in Level 1 Dry Needling and can effectively treat spine and extremity problems. Darcy Cook, MSPT has been practicing DN since 2012and is Level 2 Certified.  In addition to the Level 1 skills, Level 2 allows her to treat more specialized disorders such as TMJ disorders (temporal mandibular joint) and tension type headaches. We are seeing great results with back or neck pain, shoulder dysfunction, lower extremity pain, headaches, etc.

The goal of DN is to resolve pain, restore motion and function, and ultimately return our patients to their active lifestyles. The combination of DN with more traditional physical therapy interventions has proven to have excellent outcomes and we have found DN to be an outstanding adjunct to our practice.

Check out our website for additional information regarding needling, or give us a call and make an appointment!


Check out our tarpology! Randy has set up awesome shade for parade day!๐Ÿ‘


Check out our tarpology!  Randy has set up awesome shade for parade day!๐Ÿ‘


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