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.

At a time when technology seems to be advancing at the speed of light, research is delving deeper and deeper into our own biology for the answers to better health. Yet our country is one of the largest consumers of pain and psychotropic medication, as well as alcohol and other drugs that help us to interface with life.

Could it be that one of the challenges with our health is that our understanding of the humanities and human behavior has not kept up with the pace of technology in the natural sciences? If it piques your interest, consider attending our Speaker Series event in May.

Learn More about our Spring 2017 Speaker Series

Featuring Dr. Cathleen Beaver and Dr. Dominic Candido, founders of Enhance Health.


5:15-7:00 p.m.

Cioffredi & Associates | The Institute for Health & Human Performance

112 Etna Road, Lebanon, New Hampshire

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.

Competence and Confidence

Like healthcare, the pursuit of happiness is big business in the United States. For me, it’s important to realize that they are not the same, although they can overlap. I’m talking about the condition of happiness, not that temporary emotion whose opposite is “sadness.” The condition of happiness can include appropriate periods of feeling sad, at the loss of a friend or a pet, for example, but the condition of happiness persists. There are two elements I’ve observed that seem to be fundamental to people enjoying the condition of happiness: competence and confidence. Whether it’s in a skill or within a relationship, feeling competent and confident seems vital to success. What if you felt this way about your health?

Health and Relationships

The subtitle of Ruth Whippman’s recent book, “America the Anxious,” explains “How Our Pursuit of Happiness Is Creating a Nation of Nervous Wrecks.” If that is so, we are a less healthy nation, since there is clear biological evidence that chronic stress negatively affects our basic physiology. Whippman found evidence that yoga, meditation, and mindfulness show positive physiological effects, but her research revealed that the strongest indicator of happiness was connected to relationships.

Helping People

In our practice, people come to us primarily because they have a painful condition. I believe our greatest success is demonstrated when we can help them achieve confidence and competence in taking care of that aspect of their health. Strong relationships are fundamental to delivering on this success.

And so…to those professionals with whom we have had the pleasure to work, and to those individuals whom we’ve had the privilege to treat, I wish you a healthy and happy New Year.


William Cioffredi, PT

View  & Read the Entire Winter 2017 Newsletter Online!

Cioffredi Newsletter January 2017 Cover



Emily Milbank Joins Cioffredi & Associates Clinical Staff

Emily Milbank, PT, DPT Joins Cioffredi & Associates

We are pleased to announce the addition of Emily Milbank, PT, DPT to our clinical staff. Emily began treating and accepting new clients at the beginning of the New Year, allowing us to enhance immediate access to physical therapy care from 6:30 a.m. to 7:00 p.m. Additionally, December saw the addition of Saturday hours for Institute for Health & Human Performance massage and medically based personal training services.



Emily graduated with her Doctorate of Physical Therapy from the University of Vermont in May 2016. Prior to attending graduate school, she obtained a Bachelor of Science in Biological Sciences in 2015 while competing as a four-year member of the UVM Varsity Women’s Soccer team. In addition to her physical therapy training, Emily became a Certified Strength and Conditioning Specialist through the National Strength and Conditioning Association in June of 2012.
Emily Milbank Joins Cioffredi Clinical Staff

After recovering from an ACL injury during her collegiate career, Emily experienced firsthand the benefits of physical therapy. Her passion for athletics and personal experience with injury inspired her to pursue her interest in exercise and rehabilitation. She uses an evidence-based, integrated approach to treatment, combining manual therapy techniques, exercise prescription, and functional activities to help her patients achieve their goals.
In addition to treating musculoskeletal injuries, Emily also has an interest in treating concussion, vestibular, and neurologic diagnoses. When not in the clinic, Emily enjoys running, hiking, traveling, and spending time with family and friends.


Welcome, Emily!



Making choices about healthcare can be difficult. You want to know—upfront—what you will be expected to pay for services before you incur any costs. You have personal values, you want quality care, and you prefer to make important decisions based on evidence.Informed Healthcare Choice

Healthcare providers and insurance companies have a duty to provide information about the cost of services, and you always have options about where and how you are treated. Ask questions and do some research before you are referred for physical therapy or other healthcare services.


We’re here to help the pain go away . . . not create more. If you’d like information about the cost of our services, up front, just ask. Call us at 603-643-7788. We’re treating from 6:30 a.m. to 7:00 p.m. in 2017.


Here are some cost-comparison* resources that can help:


NH Health Cost Website

VT BCBS Website 

*Be sure that you’re comparing “apples to apples.” Costs per visit will vary between providers, and so it’s best to get detailed information directly from your provider’s office.


It’s important to consult your health insurance plan, to be sure you understand your responsibility.

  • What services are covered or excluded?
  • Do you have a deductible? Co-pay responsibility? Co-insurance coverage?
  • Are you scheduling with an in-network provider? (Check the Cioffredi In-Network Provider List)

Got Questions? Please Ask!

Call 603-643-7788 or email


empower yourself


Did Winter Sneak Up On You?


Take precautions for winter walking.

Take Steps to Prepare for Slippery Conditions

Many people spend time outdoors in the winter—working, traveling, or enjoying winter sports. When the temperatures dip (and stay) below freezing, outdoor activities can expose you to several safety hazards, but you can take steps to prepare for them and stay safe in the snow and ice.

  • Wear appropriate outdoor clothing and waterproof footwear with good treads.
  • Take short steps and walk at a slower pace so you can react quickly to a change in traction, when walking on an icy or snow-covered walkway.
  • Sprinkle cat litter or sand on icy patches.
  • Learn safety precautions to follow when outdoors.
    • Work slowly when doing outside chores.
    • Take a buddy and an emergency kit when you are participating in outdoor recreation.
    • Carry a cell phone.

More Winter Safety Resources from the CDC (U.S. Department of Health & Human Services)

Work Slowly When Doing Outside Chores

Warm up before and take breaks during shoveling snow.Shoveling snow can be a strenuous activity, particularly because cold weather can be tasking on the body. There is a potential for exhaustion, dehydration, back injuries, or heart attacks. During snow removal in addition to following the tips for avoiding cold stress, such as taking frequent breaks in warm areas, there are other precautions workers can take to avoid injuries. You should always do some basic warm-up movement and stretches before the activity. Then remember to scoop small amounts of snow at a time and where possible, push the snow instead of lifting it. The use of proper lifting technique is necessary to avoid back and other injuries when shoveling snow: keep the back straight, lift with the legs and do not turn or twist the body.

More Tips from OSHA on Winter Safety (U.S. Department of Labor)

And if winter gets the better of you, we’re here to help!

Here’s a winter injury success story to encourage you . . . #CHOOSEPT


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.



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


Nancy 1Our next FREE Fall Prevention Screenings are taking place on Wednesday, April 15th!

There is still time to register for this event! Call us at 603-643-7788 to register today.

This free one-on-one screening with one of our Physical Therapists will evaluate your balance and mobility, provide valuable insight into fall prevention, and offer solutions to decrease your risk.

Participants will need to complete a medical history and balance scale prior to their screening. The therapist will review your history, and put you through a series of test to evaluate your balance and determine your risk of fall. You will leave the screening with some tools that you can use to improve your balance.


The screening will take approximately 30 minutes, and are by appointment only. Space is limited, and pre-registration is required. Call us at 603-643-7788 to register. 



Wednesday, April 15th from 11am – 1pm and 2:30pm – 4pm


Tuesday, May 12th, 2015 from 10am – 12pm



We’re pleased to announce that starting in March we will be offering monthly FREE Fall Prevention Screenings for people ages 65 and older. Screenings will be offered by appointment only, and there are a limited number of spaces available.

This free one-on-one screening with one of our Physical Therapists will evaluate your balance and mobility, provide valuable insight into fall prevention, and offer solutions to decrease your risk.

Participants will need to complete a medical history and balance scale prior to their screening. The therapist will review your history, and put you through a series of test to evaluate your balance and determine your risk of fall. EdithYou will leave the screening with some tools that you can use to improve your balance.

Upcoming Screening Dates:

Tuesday, May 12th, 2015

10am – 12pm


Wednesday, June 10th, 2015

11AM – 1PM


TUESDAY, July 14th, 2015

10AM – 12PM


Screenings are approximately 30 minutes and are by appointment only. Space is limited, and pre-registration is required. Call us at 603-643-7788 to register. 

Find a Healthier You This Year

With Medically Based Personal Training


We are not a health club or an exclusive fitness studio. Our primary purpose is to provide an extension of our Physical Therapy service for people wishing to go beyond activities of daily living, and make a safe transition back to a more active and invigorating lifestyle.

Once a pain problem is resolved, people still can be in a physical state that is distant from their previous or desired level of activity or function. It is common to have a level of apprehension in returning to previous activities, especially for those who have a complex medical condition. Our Medically Based Personal Training service is personalized and attentive, provided in a calm yet inspiring space, and supported by doctoral level staff. Whether you are looking to return to a health club, walk the golf course, or return to the solitude of running, we are here to help you achieve your goals.

NEW YEAR’S SPECIAL: Get an 8-Pack of Personal Training Sessions for Just $499*

(A savings of $61! That’s like getting one session FREE!)
* Offer valid for new personal training clients only. Expires March 13th, 2015.