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. Continue reading


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.


Billy Cioffredi

Bill Cioffredi WEBIn my 34 years working in the healthcare field I’ve seen profound changes in the way care is delivered and have always sought out ways to better serve your needs. Now in a beautiful new facility I am excited to be able to fill in some major gaps in the continuum of health care in our area. Today at Cioffredi & Associates we can not only help you restore and maintain your health to basic levels, but can truly empower you to live the life you want to lead. I invite you to click through our website, sign up for one of our new fitness classes, or stop by our new facility any time for an impromptu tour.
In the 34 years my wife Ruth and I have worked here in the Upper Valley, we have had the pleasure to develop rich, long-standing relationships with the thousands of clients we’ve treated. We’ve also had the privilege to meet exceptional professionals in the healthcare field, allowing us to build and develop an excellent team of clinicians who have built the Cioffredi & Associates reputation by consistently delivering pain relief and exceptional care for our clients.
At the same time, we have watched our clients struggle to meet their health needs due to the interconnected and/or disjointed webs of various providers and organizations. Working with your health care provider, trying to interface with multiple groups and organizations, and hoping to cover the full spectrum of health needs in an accessible and affordable manner, is a truly daunting task.
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As we are dedicated to complimenting your Primary Care Provider and helping you improve your health while preventing chronic diseases and conditions, we have expanded our services and established a new home base to better serve you. Now, through The Institute for Health and Human Performance, we are fully able to deliver a cohesive suite of health services for people who want to achieve a higher level of mobility, strength, health and/or performance all based on our medical, scientific foundation. From Physical Therapy to Health Coaching and Nutritional Counseling, Personal Training and Group Fitness to Therapeutic Massage, you can rely on our team to give you the expertise, support, and inspiration to live a happier and healthier life.
Our new home is also a fantastic place for us to share our knowledge and the depth of understanding from others in the community, with educational seminars from a host of experts and providers in the field of overall health improvement. Whether you come to take a step forward in your fitness and health, or just want to find out more, I invite you to join us today and see for yourself what we can do for you.
Billy Cioffredi, PT
Founder & CEO