Goal-Setting Practice That Works

William J. Cioffredi, PT - FounderNew Year’s resolutions: most of us make them, and many fade by the first few months or even weeks. In our work, throughout the year, our purpose is to help people achieve their goals. We track every client, and our percentages are pretty high on helping people hit their target. This kind of goal-setting practice has reached beyond my professional life, and while I don’t profess to have great wisdom on the topic, I can tell you what has worked for me personally.

It’s pretty simple, and involves three steps.

1. Make your ‘resolution’ a specific goal that you can achieve. It’s something you can complete and is done. If your resolution is to exercise three times a week, that’s something you do—not an end result. What is your purpose with the exercise? For example, if you’d like to be able to spend a week exploring the coast with your grandkids in August or bike the Prouty in July, now you’ve created a purpose for exercising three times a week. When people come to us for help and we ask them what they want to accomplish with our treatment, oftentimes their response is something like, “reduce my pain and feel stronger.” While these kinds of responses are understandable, often one of our first tasks is to help the person identify the real purposes behind their goals (lifting their child, carrying groceries, stacking firewood?). Continue reading


A Reflection on Health

by Billy Cioffredi, PT

“John, how are your classes going this semester?”William J. Cioffredi, PT - Founder

“Hey Dad,” my son answered. “Most are really interesting. One required class in health education seemed like a dud, but then something really piqued my interest. The professor asked our class, ‘What do you feel are the top 2-3 problems in the country?’ and my classmates answered with obesity, racial injustice, sexual assault, the opioid crisis, and the like. I said community building.”

My son’s response really struck me; but why? It took me a moment to process the concept.

“John, I think you hit on something that is really important.”

There are many challenges in today’s world. I sometimes feel like there are so many different issues and special interest groups that there can’t possibly be enough time, energy, or resources for us to adequately address them all. Community building is just one thing, but it touches all the others—and it turns out that it’s also connected to our overall health. Continue reading


Mind Over Matter

Placebo, Confidence, and Certainty: Are They Related?

William J. Cioffredi, PT - FounderMike Pauletich believed he had undergone surgery to alleviate Parkinson’s symptoms during a trial at Stanford University in 2011. Parkinson’s disease is a difficult degenerative disease that has no cure, where current treatments simply try to retard the progression of the disease. The Stanford study involved both an actual and a “placebo” surgery in which a drug was or was not administered, and Mr. Pauletich not only had a good result from the study procedure, his outcomes far surpassed expectations. Many of the chronic effects he had experienced were actually reversed, such that you could hardly tell he had the disease at all. When the results came in at the conclusion of the research trial, those who received the actual treatment, on a whole, didn’t improve any better than the control group who had received a sham surgery. A researcher looking at the data afterwards noticed something remarkable: Mike had received the sham surgery! Continue reading


Iliotibial Band (ITB) SyndromeIliotibial Band (ITB) Diagram

Pain and Tightness Along the Thigh

Having pain and tightness along the side of the thigh is quite common, especially for athletes. When the pain encompasses the lower half of the thigh towards the outside area of the knee, it often carries the diagnosis of Iliotibial Band (ITB) Syndrome. For many people it can be persistent or unresponsive to typical treatment. The IT band is a stiff layer of tissue that blends from a broad attachment of muscles from the side and back of the hip. The band becomes narrower as it descends toward the knee where its attachment broadly blends with tissues about the knee cap and into the tibia bone. Continue reading


standing quad stretch

Pull one ankle back toward your buttock, bending your knee to stretch the front of your thigh.

First of all, effective stretching is not a total secret, though in my experience it is not a commonly understood concept. When we think about stretching, it’s often done with the idea that it’s like taking a piece of leather and, using force, mechanically lengthening it out. One of the problems with this idea is that ligaments and tendons are not designed to lengthen. Muscle tissue is designed to actively shorten and lengthen, however it will not lengthen effectively if it is held in an activated or tense state. Activation or tension causes muscle tissue to be more rigid—more leather-like—and it can be irritated if forced. That may be one reason some people don’t ‘enjoy’ the process of stretching. The other problem is that rigid tissue, like Turkish taffy, gets thinner and weaker as we forcibly stretch it out. That doesn’t sound good, especially to athletes who simultaneously want to optimize their strength.

Now, instead of thinking of leather that you are stretching and thinning out, think of a spring that has shortened, and your goal in stretching is to relax the tension of the spring. Continue reading


Bill Cioffredi, PT - Founder

In the bodywork and exercises that we use in our work, I often feel we are simply undoing what people have done to themselves. Most of our clients didn’t have an accident. Rather, they developed a painful condition gradually, often times without a known reason. Postural pain, as well as joint and muscle pain, are often the result of unknowingly tensing or activating muscles that don’t need to be working or are working too much for the demand. Herniated discs, sciatica, arthritis pain, and rotator cuff problems are all just examples that are influenced by this issue. To a large degree, our work in helping people to restore pain-free movement involves freeing up stiff tissues in joints. But then we need to teach people how to “relax” their muscles. “Release” may be a better term, as we want our clients to release the excessive tension and muscle activation—not have muscles go totally soft. Continue reading


Humanities and Health

Do you know someone who exercises regularly, but it’s almost a compulsive activity to “manage stress?” Controlling their weight is a constant “battle.” Going to their physician is a source of stress, as they wait to see what their numbers are going to be; worrying about their blood pressure, cholesterol, or other lab values they’re monitoring.William Cioffredi, PT

Then there’s the person for whom exercise and activity are enjoyments. They seem to eat sensibly, and you don’t hear them describing things that they should or shouldn’t be eating. They just generally seem to be happy, laugh easily, and seem confident without being cocky. They get sad in appropriate situations, but the sadness doesn’t persist. They don’t seem to be “battling” anything in their life. If they have a health problem, it doesn’t seem to dominate their life. Continue reading


Happy, Healthy New Year

The Pursuit of Happiness

“The pursuit of happiness…” Our forefathers thought it important enough to include it the Declaration of Independence, and yet I’m struck by how we, here in New England at least, seem to talk more about improving our health—and our healthcare—than we talk about our happiness (maybe happiness is more a West Coast thing?). Despite continuous advances in medicine, people are expressing more anxiety about their health to me than at any previous time in my career. As this New Year begins, my wish is that we can all achieve both.

Continue reading


Pain, Resilience, and Opportunity

by Bill Cioffredi, PT

Physical Therapist Bill Cioffredi, Founder of Cioffredi & Associates | The Institute for Health & Human Performance on PAIN AND RESILIENCE: AN OPPORTUNITY

Over the course of my 30-plus-year career as a physical therapist, I have gotten a lot of satisfaction from helping people deal with what I saw as a lot of mechanical kinds of pain, and if I could help them with their pain through understanding the biomechanics and correcting things, it was really terrific.

More Than Mechanics

But I noticed, over time, more and more people who had histories of anxiety issues, panic attack problems, nervousness, and depression—and many people were on medications for these kinds of things. I began to see that there was a lot more than mechanics behind the pain problems of the people that I was seeing, and I realized that I really needed to get better at understanding that kind of “needingness” to really help people further.

I consider it an interesting paradox that there are now ways, through healthcare, that allow people to live a lot longer than they used to. The question and the challenge that follows is, “Are they, are we, living happier?” especially over those longer periods. This is where the concepts of pain and resilience and opportunity converge.

Building Competence and Confidence

As physical therapists, we have the pleasure to treat people when they come to us because they have a pain problem, and through our work with them we help them develop their competence. But in fact we also have an opportunity to help them develop their confidence—confidence that they can handle whatever it is that’s giving them trouble. It’s true that they usually come to us because they’ve got a pain problem, but you can almost take that concept of the “pain problem” and insert just “problem,” and then what we’re doing is building people’s competence and confidence to handle whatever is in front of them.

And so the topic of resilience is very interesting to me for those reasons, not only just for the pain problems that we see people for, but for the “livingness” parts of things. I have developed a deeper appreciation that when I provide care with this in mind, the pain condition becomes an opportunity…both for the person I’m treating and for me.

Dr. Adam Schwarz Presents The Clinical Science of Resiliency, part of PAIN AND RESILIENCY: AN OPPORTUNITY

LEARN MORE about Pain and Resiliency

I was honored to host Dr. Adam Schwarz of the Hanover Continuity Clinic as the featured presenter at our Fall Speaker Series event on November 2, 2016, and his lecture “The Clinical Science of Resiliency” is available to view on the Cioffredi & Associates YouTube channel.

WATCH NOW


Website-blog-post-Dennis

Dear Dennis,

I wanted to thank you for your time to come and speak at the Institute’s Spring Speaker Series. You should know that so many of the people attending had thanked me for the program and for your presence. You touched so many people.

You’ve earned a reputation as a thoughtful and effective physician. My guess is you would have had a similar reputation in any other field you might have gone into. You came to the Upper Valley just a few years before me, and I’ve observed your style for some time. Based on what I’ve seen, this is how it breaks down for me: It starts with genuinely being interested in the person in front of you; being able to communicate with that person through listening, duplicating their viewpoints, and acknowledging them without judging. In finding some element you can admire in each individual, and then helping them achieve what they want, in whatever way they can accept it. I think that’s how you created the strong, lasting relationships that were your hallmark. It seems to me that is also the way you lived your life. You were married to the original gal for 45 years…and happily married. In this time of “evidence-based practice,” there’s the evidence.

I think society has been struggling here a bit Dennis. Technology can be a nice tool, as long as we don’t let it confuse us or interfere with our ability to build relationships with our patients. Thank you for everything Dennis. You really made a difference. I will remember you as I continue to apply what I’ve learned from you in my personal life as well as my professional life.

Appreciatively,

Billy Cioffredi