What is the Rotator Cuff?

It’s Simple: The Rotator Cuff is a group of five muscles. When functioning well, they work in harmony to keep the ball in the center of the socket of the shoulder joint when we reach and lift with our arms. These muscles are designed to control the contact surfaces of the two bones of the shoulder rather than primarily providing the power needed for heavy work. As a result, injuries can occur from sustained workloads near the limits of their capacity or by a sudden overload. In the case of a minor strain or ‘tear,” with proper care, your shoulder may heal fully and cause no long-standing problem. A larger strain/tear though, will require surgical intervention or result in permanent weakness, inhibited mobility, and pain.

The Mystery

What isn’t as commonly known about the rotator cuff is that the design of our shoulder joint includes an archway that projects out over the socket. This plays a large factor in shoulder pain, particularly if your posture is abnormal. Because of the design of this structure, when alignment is off, the tissue can chafe and wear. In a “normal”, optimal alignment, there is a maximal amount of space in the archway where the muscles pass through as seen in the picture to the right here. But, when we work at a computer, in the kitchen, or at a workbench with our shoulders rounded forward, it reduces the space in the archway where the muscles can rub against it. Over time, this can add “wear” to the muscle-tendon unit. In a “worn” condition, the rotator cuff muscle group is more susceptible to the types of injuries noted above.

Over time, poor postures result in adaptive changes to the muscles and tendons. Some muscles become weak from limited use or being overstretched. Others become tight from not being used in full, lengthened ranges. Muscles become out of balance and this pulls the joints out of optimal alignment. The good news is that abnormal postures, adaptive muscle changes, and minor and moderate muscle strains can be helped.


With proper care, tight muscles can be lengthened to restore flexibility and weak muscles can be strengthened. Abnormal postures and movement patterns can be retrained. Whether at work, in leisure, or in athletics, these can be corrected. This may require advanced physical therapy skills including manual techniques, corrective movement exercise and ergonomics. While rest and medication may be important elements in recovery, addressing these other elements may be the difference between a deteriorating condition with lost function, and a complete recovery.



12 Throwing Exercises to Save Your Season

Kinesiology Tape: What and Why?

Our Team

We are very proud to announce that Marissa Reilly, DPT of Cioffredi & Associates in Lebanon has completed her Certified Mulligan Practitioner (CMP) certification.  Marissa leads up our Sports Performance Program and adds this certification to her existing qualifications as a Physical Therapy Doctorate, Athletic Trainer, and Strength and Conditioning Specialist.

What is The Mulligan Concept?

The Mulligan Concept is an advanced set of specific manual therapy skills geared towards joint treatment when pain and range of motion are involved. It is especially helpful for the spine with immediate and usually long-standing reductions in pain, and improved function/ROM.  The basic concept is that, by applying an appropriate force to an affected joint while a patient moves in the direction of pain, it will eventually reduce pain and improve motion. Learn more about the Mulligan Certification here.

By acquiring this certification, Marissa becomes one of four CMPs in the state of NH and is now regularly utilizing Mulligan mobilization with movement concepts into her treatments with clients. Please join us in congratulating her on this great achievement!

Our Team

Two PTs Acquire Advanced Orthopedic Certifications

Our Commitment to Education


One year ago, we opened up our second clinic to bring our service and expertise to Grantham, Eastman, New London, and the Greater Lake Sunapee region.

Your overwhelming support has brought us from operating initially with just one part-time therapist to a consistently busy and thriving clinic with two full-time therapists. We are so grateful for our patients and the greater community who have embraced us and we want to give back – to celebrate our the landmark of 1 year in business, we are throwing the doors open and raffling off all sorts of great prizes in thanks!


Cioffredi & Associates Physical Therapy

151 Route 10N • Grantham Greenway • Grantham, NH



• Massages • Gift Cards • Foam Rollers • T-Shirts • And More! •


Q&A with our PTs, Year in Video, Cutting of the [Cup]Cakes, Drinks, & Raffle!

To see raffle winners as well as informational articles, pictures, and videos from our clinic, our community, and the wellness world!



Grantham Office

Final Push to Open

We Welcome Another PT to Grantham!



In this issue…

✓ The Horse Whisperer: Building Positive Relationships

✓ Spring Sport Preparation: PT Gives You the Edge

✓ In Their Own Words: Success Stories from Our Patients

✓ What is Vertigo? It’s All in Your Head!

✓ Overcoming Opiods: Managing Your Pain

✓ A Special Invitation to Grantham’s First Birthday


(Use the [  ] symbol in the center or lower right to view in fullscreen mode.)

In late 2017, Kris Bowen came to us with knee pain so severe she was unable to walk up and down stairs. Recently, she was able to partake in the experience of a lifetime, hiking all over rocky coast of Scotland!

“I just wanted to share this picture of me in Scotland celebrating my 50th birthday! When we started working together a year ago, this was my goal. For over two weeks we walked rocky beaches in the Inner Hebrides islands. We hiked on steep and muddy paths through the Highlands. We got to experience so much beauty on the trip of a lifetime. My knee felt great! I took my time on some of the trickier terrain (I like to think of it as contemplative walking) and the hiking poles were an excellent asset to have along. But overall, I just felt strong and ready to take on all the fantastic adventures we waded into. Thank you so very much for your help getting my knee back in shape so I could have this wonderful experience!” -Kris Bowen

Sports Injury Recovery

Knee Pain: Finding the Source

Hiking Exercises




Stories of Health, Wellness, and Resolutions | Tips and Inspiration for the New Year


In this issue…

✓ 9 Things I Learned from Actor Michael Caine

✓ Q&A with Jim Beattie: Leading an Active Life Post-MLB

✓ Avoiding Spine Surgery

✓ In Their Own Words: Success Stories from Our Patients

✓ Grantham Gurus: 5 Tips to Keep Your Resolution

✓ Sports Massage and You

✓ Where Are They Now?


Client Success: In Her Own Words

I have been living with chronic lower back pain for years and finally have gotten relief through just a few sessions of dry needling with Marsha and Becca. 

“I am thrilled to have relief and know that dry needling is a resource for this discomfort should I experience it again. Thank you Kate, Becca and Marsha!”

This back pain has affected my quality of life and sleep. I exercise, stretch, have tried massage and over the counter pain medication but have only gotten very temporary relief. My physical therapist, Kate, thought that perhaps I would benefit from some dry needling. Continue reading