Performance PT Care Magazine by Rhode Island Small Business Journal

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Issue #6

Concussion Awareness & Treatment Advice From a local physician, physical therapist & athletic trainer

SEE INSIDE: Got Pain? Dry Needling may be the Answer

A Healthier Life Five Simple Secrets to Leading a Healthier Life A Matter of Balance: Managing Concerns about Falls Exercise for Managing Diabetes ...and more!

Running: Keeping you ON PACE Running in our Community The Performance Running Analysis From 5Kâ&#x20AC;&#x2122;s to Marathons, Local Success Stories

Returning to Pre-Pregnancy Shape In the Community Reach Out and Read, Girls On The Run, Ronald McDonald House, Make a Wish and more...

contents 3

In the Community

A Time For Growth

See what Performance has been up to in the community

This last year has brought construction, expansion, relocations and new clinics!

Getting To Know Our Team Dave Pavao, Kerry Giroux, Brian Hay & Kevin Silvia

Reach Out and Read RI Turns Fifteen in 2014

Got Pain? Dry Needling May Be the Answer! A new treatment technique with immediate and impressive results

Running • Keeping you ON PACE • Running With a Group • Girls on the Run Rhode Island: Running with Purpose • Running for Good: Ronald McDonald House Women’s 5K • Running in the Community • Profiles on Local Runners • It’s Time for a Performance Running Analysis

Returning to Pre-Pregnancy Shape

Programs

Guidence on returning to exercise after pregnancy

Gym Program, Personal Training, The Performance Movement Screen, Aquatics, Pilates, Massage Therapy, Occupational Health, Hand Therapy, Pediatrics and Oncology

Living a Healthier Life • Are Health Problems Stopping You From Enjoying Life? • Five Simple Secrets to Leading a Healthier Life • The Benefits of Exercise in Managing Diabetes • A Matter of Balance: Managing Concerns about Falls

Concussion Awarenes and Treatment • Its Not Getting Your Bell Rung • Think Straight: How Physical Therapy Helps Accelerate Concussion Recovery • An Athletic Trainer’s Advice on Concussions

Athletics • USA Today Names Sandy Gorham Coach of the Year! • Athletic Training and the Performance Speed School. A Stronger, Faster You. • A Tribute to Ronnie McFarland • Lincoln School Student Profiles

Care at Its Best Magazine Editor Michelle Collie PT, DPT, MS, OCS

Assistant Editors Susanna Beckwith Connor Maguire

Contributors

Brian Hay MSPT, DPT, OCS Kim Chula-Maguire DPT Jennifer Reynolds DPT Amanda Moran ATC, LMT Dave Pavao DPT, OCS, CSCS Molly Smith DPT Bethany Carnevale DPT

Designer Mai-Lis Tria

Photographer Chip Reigal Published by Performance etc, ©2014 Requests for permission to reprint should be sent to Michelle Collie, Performance Physical Therapy, 1525 Wampanoag Trail, Suite 205, East Providence, RI 02915, or emailed to mcollie@performanceptri.com

on the cover Got Pain? . . . . . . . . . . . . . . . . . . . . . . . 15 Running: Keeping You ON PACE. . . . . . .18 Returning to Pre-Pregnancy Shape . . . . . 30 Living A Healthier Life. . . . . . . . . . . . . . .40 Concussion Awareness & Treatment . . . . 44

21 Performance Physical Therapy is a state-of the-art, physical therapy practice offering a variety of innovative services that help patients of all ages achieve optimal physical function – fitness, wellness and rehabilitation. Performance specializes in sports injuries, spinal, orthopedic and post-surgical conditions, and creates a variety of strength and wellness strategies to help patients heal fully and quickly. With the largest number of board-certified physical therapists in the state of Rhode Island, Performance is a leader in the health care community. Performance Physical Therapy is known for their customer care, friendly staff and dedication to providing the latest solutions to their patients. This publication is offered to provide education and resources to patients, the general public and other health care providers. It is not designed to replace the relationships people have with their health care providers. For more information and to view previous editions of Care at its best, please visit; www.performanceptri.com.

from the editor

Michelle Collie PT, DPT, MS, OCS

performance in the community

he delivery of health care is changing and it is an exciting time for Performance Physical Therapy as we lead the way by providing valuable physical therapy care and services. Orthopedic board-certified clinical specialists, a post-graduate clinical residency, clinicians certified in dry needling, and ongoing assessment of clinical outcomes and patient satisfaction are all investments we have made to ensure that your time spent at Performance is time well spent. The successful growth and evolution of Performance over the last 18 months can be credited to our team of passionate individuals providing care at its best and embodying the values of Performance. But it is our patients and the communities we serve that really deserve our acknowledgment and gratitude for supporting our growth. Word of mouth referrals and patient loyalty are what we depend on to survive, grow and evolve. We are committed to providing high quality care to every patient we serve. I truly am grateful for all who have supported Performance and do hope you enjoy this 6th edition of Care at its Best. In addition to valuable health, wellness and fitness resources, I am excited to share profiles of people from our Performance community, including patients and clinicians. As always, I welcome feedback on how we can serve our communities better.

Best of health, wellness and fitness,

Michelle 2 |

Care at Its Best

1. Crossroads. Lisa Decoste MSPT, DPT, OCS, Kara Chace DPT, LATC, Yvonne Swanson MSPT, OCS, Jen Reynolds DPT, Megan Marcello MSPT, OCS and Andrea Mitchell MSPT, LMT supporting Crossroads at the annual Women Helping Women event. 2. Respect to Boston. School Street shows their Boston Pride after the Boston Marathon tragedy. Pictured Rick Young BA, PTA, CSCS, Ashley Silviera, Dawn Daniels, Andrew Horton DPT, CSCS, Alex Neal DPT, and Bob Doherty PTA, BS, LATC.

1 The First Shovel ceremony for construction at 21 Division Street, Pawtucket. The new clinic will offer a large gym, additional fitness programs and a state of the art, Hydroworx pool and an Alter-G treadmill. The clinic is scheduled to open later in 2014. Follow us on Facebook (facebook.com/performanceptri) and Twitter (twitter.com/PerformancePTRI) to stay up to date with construction, expansions and openings.

4. Reach Out and Read. Michelle Collie PT, DPT, MS, OCS, Lisa Decoste MSPT, DPT, OCS and Brian Hay MSPT, DPT, OCS pictured at the annual breakfast.

Clinic Director Andrea Mitchell MSPT, LMT and Michelle Collie PT, DPT, MS, OCS discuss health and wellness programs at the new East Side clinic.

7. Team Henry. Gerry Fox and Kelly Aziz shaved their heads after raising over $1000 for Team Henry and the fight against Pediatric cancer.

Our 10 Core Values... 1. Help Others 2. Deliver the Best Care 3. Actively Embrace Change 4. Pursue Professional Growth

9. Promote Happiness

5. Invest in Relationships

10. Demonstrate Professionalism

6. Be Kind

7. Hard Working and Accountable 8. Passionately Advocate for our Patients and Profession

5. PPAC. Andrea Mitchell MSPT, LMT helped the cast of ONCE put on a great show at PPAC! 6. Gloria Gemma Foundation. The Seekonk Street staff, pretty in pink! Pictured Tracy Traskauskas, Rob Gruttadauria DPT, Pat Sturdahl, Max McKinney DPT and Andrea Mitchell MSPT, LMT.

Representing our culture, our brand and our future.

3. Annual School Drive. School nurse, Lynn Deschepper of Carl G Lauro Elementary School in Providence accepts school supplies collected during the school drive from Nick Valletta.

8. Team Henry. Kelly Aziz, Kara Sousa MSPT and Jaimie Fellela BS, PTA sport Team Henry T-Shirts during dress down days to raise funds for Team Henry 9. Operation Holiday Cheer. Kevin McDonald, Bob Lovell*, Lisa Smith, Lt. Governor Elizabeth Roberts, Gary Rehak*, Daniel Thurston* and Russ Bernine accept donations from Performance. (*Members of the Combat Veterans Association)

continued...

• PATIENT STORY • see what we’ve been up to...

A New Lease on Life

10. The Providence Center. Performance collected over 100 coats during the 2nd annual coat drive. Pictured Chris Hughes and Russ Cooney from the Providence Center.

Local business woman Jan Grinnell gets a new lease on life and offers advice to others.

11. Rhode Island Blood Center. Melissa Robidoux DPT, Todd Swanson and Jessica Boule-Kosegarten donate blood. 12. Cops For Cancer. A Paint and Vino night raised money for Ashley Glenn’s fundraising campaign. Pictured Michelle Collie PT, DPT, MS, OCS, Anne Luther, Fatima Semedo, Lisa DeCoste MSPT, DPT, OCS, Melissa Robidoux DPT, Ashley Glenn DPT, CKTPA, Christine Amaral, Jaimie Fellela BS, PTA, Carolyn Tomasello DPT and Kerry Giroux MSPT, CSCS.

13. Heart Disease Awareness. Performance had fun raising awareness. Pictured Jessica Boule-Kosegarten, Melissa Robidoux DPT, Dave Pavao DPT, OCS, CSCS, Nick Valletta, Chris Hughes, Lisa DeCoste MSPT, DPT, OCS, Michelle Collie PT, DPT, MS, OCS and Yvonne Swanson MSPT, OCS. 14. National Dog Day. Chloe and Kai join Michelle Collie PT, DPT, MS, OCS and Andrea Mitchell MSPT, LMT and help patients smile!

11 15

15. Celebrating 1 Year. The Smithfield clinic won the ugly holiday sweater competition and celebrated 1 year of being open. Pictured Ashley Glenn DPT, CKTPA, Joseph Russolello DPT, Dave Pavao DPT, OCS, CSCS, Jaimie Fellela BS, PTA, Melissa Charette, Kerry Giroux MSPT, CSCS and Tori Costa LMT, SPTA. 16. Shoulder To Shoulder. Performance supporting Shoulder to Shoulder at Waterman Grille. Nick Valletta, Chris Hughes, Max McKinney DPT, Dave Pavao DPT, OCS, Michelle Collie PT, DPT, MS, OCS, Andrea Mitchell MSPT, LMT, Lisa DeCoste MSPT, DPT, OCS, Brian Hay MSPT, DPT, OCS and Jessica Hay CNPN-AC. 17. RIFit and RISBJ. John Resnick (founder of RIFit) and Gil Lantini (founder of RISBJ) collaborate with Michelle Collie PT, DPT, MS, OCS and Chris Hughes.

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Care at Its Best

16 12

What brought you to Physical Therapy? I was 65 years old and have been in physical therapy several times during the past 15 years. I have suffered many injuries in my lifetime, (several significant ones over the last several years) and I have a small amount of arthritis, too. I started working with a personal trainer this past winter and awakened many of the old injuries that never really healed properly. My primary care physician recommended that I start PT to complement my work with the personal trainer and ongoing chiropractic care. She recommended Performance PT, and after calling I ended up with an appointment at the new East Greenwich facility with Yvonne and Jesse.

Are you working? Yes, I own my own small IT Consulting company and I am also the Archdeacon of the Episcopal Diocese of Rhode Island. What do you normally do for exercise and recreation? I like to walk in good weather, and use the recumbent bike during bad weather. I enjoy playing golf. Do you have advice for people who say they “don’t have time to exercise?” I continue to struggle with this in my own life, because of the many things that I am involved with. My life is very busy, and I do not do a good job of being diligent about exercise. But my advice is to not give into the thinking that “if I don’t do it as much as I should, then I should stop trying.” My advice is to never stop trying to find the time to exercise.

When you began at Performance, please describe how your problem was affecting your life. I was in constant pain with my neck and shoulder and it was limiting my ability to work. As an owner of a small business, it was critical for me to be able to sit and work at my desk for extended periods of time. I was also uncomfortable doing other routine activities of everyday life.

What are your health and fitness goals for the year ahead? Eat properly, keep my weight under control by not overeating, and exercise, stretch, exercise, stretch, exercise, stretch...

How did physical therapy change your life? As I told Yvonne, I felt like I was given a ‘new lease on life’ after a week of vacation where I was able to do many physical activities pain free.

How do you stay healthy? I try to eat properly, exercise, and “listen to my body” when I am feeling stressed. Also, I think spiritual health is a large contributor to mental and physical health.

Is there fitness device or gadget that you can’t live without? Recumbent bike and theraband for stretching my shoulder

What do you do to relax? Watch sports! I love the Red Sox and Patriots! I also garden and spend time with friends. We do a lot of traveling too, since our four adult children live all over the country! Which sports teams do you cheer for? In addition to the Red Sox and Patriots, I also cheer for Penn State, Texas A&M, and TCU in college football. If you could possess one superhuman power, what would it be? I would love to help others believe that they are perfect creations and loved unconditionally. Life is not a test where we get a pass/fail grade. Life is knowing that we are loved. People like Yvonne and Jesse affirm that in my life, and I would love to be able to do that for others!

a time for growth... This last year has brought construction, expansion, relocations and new clinics!

North Providence In September of 2013 the North Providence Clinic relocated to a significantly larger clinic at 1401 Douglas Avenue, allowing extended hours, additional staff and services. 1. Chris Hughes, Lisa DeCoste MSPT, DPT, OCS, Mayor Lombardi, Michelle Collie PT, DPT, MS, OCS, and Senator Dan Issa at the North Providence Grand Opening. 2. The North Providence team; Molly Smith DPT, Brittany DiScuillo, Kara Sousa MSPT, Kelly Aziz and Kareem Kobeissi DPT. 3. Kara Sousa MSPT is introduced to Molly Smith’s DPT parents and grandmother at the official opening.

East Greenwich Performance Physical Therapy was welcomed to 5750 Post Rd, East Greenwich in early 2013. This clinic is led by Yvonne Swanson MSPT, OCS who has been at Performance since 2004. A 1999 physical therapy graduate from the University of Rhode Island, Yvonne is also a Board Certified Orthopedic Clinical Specialist and Certified in Dry Needling. 1. Chris Hughes, Elaine Narducci (AtMED) Yvonne Swanson MSPT, OCS, Jessica Boule-Kosgarten, Pamela Mitchell (AtMED) and Nick Valetta. 2. The official ribbon cutting, celebrating the opening of Performance in East Greenwich. Front row: Chris Hughes, Councilman Mark Gee-Town, EG-Town Manager Thomas Coyler, EG Chamber Executive Director Seve Lombardi, Yvonne Swanson MSPT, OCS, Dr. Jeffery Manning (Affinity Sports Medicine), Michelle Collie PT, MS, DPT, OCS, Dr.Michael Rocchio (AtMED), Nick Valletta 2nd Row: Bill Durst (AtMED), Ellen Brady (AtMED) , Kim Schofield (AtMED), Pamela Mitchell (AtMED), Jessica BouleKosgarten, Melissa Robidoux DPT, Marie Dubuc (Affinity), Dr. David Bica (Affinity Sports Medicine).

Pawtucket Woonsocket In January 2014 Physical Therapy Plus merged its Woonsocket clinic with Performance Physical Therapy. Tom Harrington PT, opened Physical Therapy Plus, l ocated at 16 Arnold St, Woonsocket in 1986.

Construction is underway for a new health care facility at 21 Division St, Pawtucket, a project initiated and lead by Dr. Pablo Rodriguez, CEO of Women’s Care. Performance will utilize over 8,000 sq feet, offering expanded therapy services in an in-door and out-door gym area plus offer aquatics in a state of the art, Hydroworx therapy pool. 1. The Performance team with Dr Emily Harrison and Dr Pablo Rodriguez of Women’s Care. 2. An image of the proposed clinic, opening later in 2014.

East Side 2014 saw the relocation and expansion of the East Side clinic to 49 Seekonk St, Providence. Clinic Director Andrea Mitchell, MSPT, LMT states, “It has been my vision and goal to lead a clinic that offers not only physical therapy, but also pilates, personal training, boot camps, massage therapy and more”.

Tim Keohane PTA, ATC, Erin Laprade, Kristen Morais MSPT, Stephanie Tanzi, Julie Guertin PTA and Lisa DeCoste MSPT, DPT, OCS dress in red to increase awareness of Heart Disease.

Follow us on Facebook (facebook.com/performanceptri) and Twitter (twitter.com/PerformancePTRI) to stay up to date with construction, expansions and openings... 6 |

Care at Its Best

getting to know our team... Kerry Giroux

David Pavao

An Athlete, a Mother and a Physical Therapist

Smithfield Forever!

Kerry Giroux MSPT, CSCS decided to become a physical therapist at 12 years of age. A successful athlete and student, she attended the University of Rhode Island, receiving her Bachelor of Science in Physical Education with a concentration in Physical Fitness and her Masters of Science in Physical Therapy in 2001. Kerry joined the Performance team in 2005.

Dave Pavao, DPT, OCS, CSCS was born in Smithfield, raised in Smithfield and has returned, leading a successful Performance clinic just minutes from his new home. Dave joined the Performance team in 2009. He graduated from the University of Rhode Island with his Doctorate in Physical Therapy in2009 where received the “Academic Excellence Award” at graduation. In 2012 Dave completed an Orthopedic Residency with Evidence and Motion and went on to become a Board Certified Orthopedic Clinical Specialist. He became certified in Dry Needling in 2013. In May of 2013 Dave was awarded the “Outstanding Alumni Award” from the University of Rhode Island. Dave is currently the Director of Clinical Standards at Performance and the clinic director at the Smithfield clinic. Dave oversees and ensures Performance is providing the most current and up to date treatment. He is known for his tireless dedication to physical therapy and for providing endless resources and guidance to guarantee Performance is providing the best care possible. Dave is a clinical instructor at URI and a mentor and instructor for Brown Medicine residents as they complete affiliations at Performance Physical Therapy. Dave is a faculty member for the Performance Residency Program.

Photo: Kerry Giroux MSPT, CSCS pictured with fellow High School Athletic Hall of Fame Inductee, Marisa Petreccia. Photo: Dave Pavao DPT, CSCS, OCS is congratulated on receiving the “Outstanding Alumni Award” by Dr. Pete Blanpied, PhD, PT, OCS, FAAOMPT, Professor from the University of Rhode Island

What are your greatest joys of being a physical therapist? I love the endless challenges that physical

the gym for some weight training and beat my brother in tennis when I get the chance.

therapy offers. This of course begins with becoming a better therapist every single day, but also extends to being a better colleague, manager, and overall problem solver.

What advice do you have for people who say they “don’t have time to exercise?” I think I can

What are the biggest challenges of being a physical therapist? You can never stand still. You always need to be improving as a therapist, in terms of both keeping up with the latest evidence as well as developing how you communicate and interact with patients and colleagues.

What accomplishments or goals are you most proud of? I’m proud of the physical therapist I have become over the past 5 years. I always felt that this was a profession that offered so many opportunities, and I think I have done my best to take advantage of the opportunities I’ve had, from teaching the next generation of students at URI to becoming a partner and clinic director with Performance as I help to grow a clinic in my hometown of Smithfield.

What do you do for exercise? I would consider myself a ‘casual runner’, always up for a 5k when there is some food and drink waiting for me at the finish line. I also like to get to

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Kerry has over 12 years of clinical experience and sees patients at the Smithfield clinic. She specializes in general and post-surgical orthopedics, shoulder and knee rehabilitation and sports injuries. Kerry’s athletic experience, abilities and awards including an induction into the New England Basketball Hall of Fame and her high school’s Athletic Hall of Fame—and she is also the mother of 2 boys.

Care at Its Best

relate to patients pretty well, in that I often ‘fall off the wagon’ myself whenever my schedules changes or life gets busy. But I like to keep things simple by telling patients to pick activities and exercises they enjoy, because if you don’t enjoy it, you won’t do it.

Do you have any advice for people living in pain? Almost all patients coming to us for treatment do so

Why did you decide to become a physical therapist? When I was 12 years old, I injured my ankle running to first base during the state championship softball game. My team went on to win the championship and a berth in the National Tournament 2 weeks later in Georgia. It was such an exciting time for the team! But after a trip to the Emergency Room, I was put on crutches and told I would not be able to play for 3-6 weeks. My mom was able to get an appointment with an orthopedic surgeon later that week. Soon after, a physical therapist met with me and showed me how to walk without crutches and provided exercises for me to do. Two weeks later, I was running the bases in Georgia with my teammates. At 12 years old, that physical therapist made such a huge impact on me and I told my mom that afternoon I wanted to be a physical therapist.

What do you enjoy about being a physical therapist? Meeting a complete stranger who is dealing

college. I was the Rhode Island High School Athlete of the Year my senior year and received a full athletic scholarship to play Division 1 basketball at URI. I was recently inducted into the New England Basketball Hall of Fame and my high school’s Athletic Hall of Fame in West Warwick, RI. My greatest accomplishment, however, is giving birth to my 2 wonderful sons: Garrett (6) and Luke (3).

What advice do you have for people who say they “don’t have time to exercise?” There was a time when I felt the same way. I was discouraged when I couldn’t find 30-60 minutes a day to workout. But I would try to do things throughout the day to stay active and get my heart rate up: park far away in the parking lot from a store/mall, always take the stairs, do sprints in the back yard with the boys, even doing squats while brushing my teeth!

because of pain – both acute and chronic. I think their first priority should be finding a physician and physical therapist they trust and that truly listens to them. Pain is multifaceted and often requires a combination of the right treatments at the right times to overcome it.

with pain and/or some limitation and getting them to trust you completely is rewarding. I enjoy helping them achieve their physical therapy goals and return to all their previous activities. The greatest joy can also be a great challenge!

typical New England Sports fan: Red sox, Celtics, Bruins..... but MY team is the Patriots! My weekends in the fall revolve around what time the Pats are on! And I am a big fan of college basketball, especially March Madness!

What are your health and fitness goals for the year ahead? I plan to complete my third Tough Mudder

What accomplishments or goals are you most proud of? I was fortunate enough to part of some great

If you could possess one super-human power, what would it be? To be able to snap my fingers and be

obstacle course race with a group of college buddies. And hopefully, the third time is the charm for parlaying that race into finally training for and running a half marathon.

athletic teams and play alongside wonderful teammates who helped me achieve many athletic awards in high school and

Which sports teams do you cheer for? I am a

anywhere in the world in a second.

• MAKE A W I SH •

Brian Hay A Performance “Townie” Brian Hay, MSPT, DPT, OCS is one of Performance Physical Therapy’s many “townies,” having attended East Providence High School. Brian joined the Performance team in 2004 upon graduating from the University of New England in Maine. He went on the receive his Doctorate in 2009, became a Board Certified Orthopedic Specialist in 2007 and was Dry Needling Certified in 2013. Brian is currently the Director of Programs at Performance and the clinic director at the Pawtucket clinic. He is a clinical instructor for physical therapy students, a mentor for Brown students and a faculty member for the Performance Residency Program. Brian has been instrumental in developing the programs Performance provides for high school athletes, the Performance Speed School and for developing the Performance Running Screen. In February of 2011, Brian travelled to Honduras for a week to volunteer with Shoulder to Shoulder. He continues to be very active in fundraising efforts with this organization. An avid runner, Brian has now run 10 marathons, completed a 50K trail run and a 50 mile trail run!

What are your greatest joys of being a physical therapist? The satisfaction you get when a patient you’re working with is able to return to doing something they love after thinking they would not be able to do it again.

What are the biggest challenges of being a physical therapist? Understanding that no two people or injuries are alike and every case has to be completely individualized.

How do you stay current with physical therapy treatment? I am a member of the American Physical Therapy Association (APTA) which provides well researched studies on a regular basis. I also subscribe to some recordable websites and journals that provide constant updates on the latest evidence based treatments. At Performance, we work with a lot of PT students and offer an in-house residency program. As an instructor in the program, I have found that students, more than ever, are up to date on the latest PT news. So, it is imperative that we as instructors are on top of the research as well.

What accomplishments or goals are you most proud of? I am proud of being a Board Certified Orthopedic

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Why did you choose this organization to support?

and friends or take a hike with my dog, Maggie.

I choose this organization because of the work it does for small but very brave children. The happiness you can give a child is the best reward you can ever receive!

What advice do you have for people who say they “don’t have time to exercise?” There is always time! You just have to find little ways to work it into your schedule. Make a rule not to take the elevator (or escalator), park at the back of the lot, do ten squats and push-ups every T.V. commercial, jog in place while the coffee is brewing, etc. Exercise doesn’t have to require a fancy gym or treadmill, it just needs to become a habit. Make exercise a priority; it is the best thing you can do to stay healthy.

Do you have any advice for people living in pain? I have written in my office “Pain is temporary.” Pain is not a normal process for the body. Therefore your body is constantly attempting to get rid of it. Knowing that pain is not permanent and understanding that it does not need to define what you are able to do is the first step to getting rid of the pain. Get active, and talk with a physical therapist who can teach you how to be active in a safe and effective way.

What are your health and fitness goals for the year ahead? I would like to finish a marathon in under 3 hours.

What do you do for exercise? I run mostly and when

If you could possess one super-human power, what would it be? Time Travel.

Care at Its Best

Kevin Silvia PTA, CSCS, has been with Performance for 10 years. A graduate from URI and CCRI, he has always been involved in health and fitness. Four years ago Kevin became involved with The Make A Wish Foundation, a non-profit organization that grants wishes to children with life threatening medical conditions. His interest has evolved into Kevin now leading an annual, fundraising effort by the physical therapy community state wide.

What do you do to relax? Spend time with my family

Specialist. And I am most proud of the fact that four of my former clinical PT students came to work at Performance upon graduation with their doctorate and are now amazing clinicians, and teaching students of their own. However, this does make me feel old! I can, I will do some resistance training.

Silvia Makes Wishes Come True...

Do you have a favorite song to exercise to? I usually do audiobooks, but if it’s music, it is usually anything by the Red Hot Chili Peppers.

How did you get so many people involved in this fundraiser?

three year old Angeles who spent most of her time in hospitals watching Dora the Explorer wished to go to Disney World to meet Dora.

How much money have you raised to date and what are your upcoming goals? To date we have raised over $19,000.00. Our goal each year is to fulfill the wish of one child. For me that is the most rewarding. To read and hear the stories of these children who want a family vacation to Disney, shopping sprees for their siblings and friends demonstrates how brave and selfless they really are. They are truly brave heroes! I recommend everyone should become involved in volunteering. It is a very humbling experience.

Being in the physical therapy field for the past 15 years, I had made many friends. I decided to utilize my relationships with other clinicians, private physical therapy clinic owners, hospitals, nursing homes and colleges to begin raising awareness and funds for Make A Wish. As I began calling my colleagues, I received tremendous support and recommendations for other clinics to join our cause. In October 2010, I founded the RI Physical Therapy Fundraiser. We are in our fourth year now, and still have support from everyone.

Can you tell us about a wish that came true for a child, as a result of your efforts? We have been able to fulfill the wishes of three children to date, one each year. Aidan our first year “wish child” wished to go to the Star War’s convention at Disney’s Studios. Eric our second year child wished to take his sister and his best friend on a shopping spree at the Providence Place Mall. And last year,

Pictured are the Friendly Nursing Home employees with PPT’s Kevin Silvia, PTA, BS, CSCS who were the recipients of the pizza party for collecting the most donations during the 2012 Make-A-Wish fundraiser.

each Out and Read Rhode Island is an evi-

school. Did you know that nationwide nearly 90% of

dence-based nonprofit organization that pro-

all young children visit their doctors at least annually,

motes early literacy and school readiness in

while less than 1/3rd are enrolled in any childcare

pediatric exam rooms statewide by giving new books

setting? Because of our cooperation with pediatri-

to children and advice to parents about the impor-

cians and family physicians, those who implement the

tance of reading aloud.

Reach Out and Read model, our literacy program is afforded a higher degree of access to preschool age

This year Reach Out and Read RI is marking its 15th

children than any other literacy program in existence.

anniversary and we’re doing so with both celebration and gratitude. We’re celebrating our growth - starting

This brings us to what we are grateful for, our pro-

with only five participating sites in 1999 we’ve grown

viders, 250 strong, who have adopted the Reach Out

to support forty-five sites in 2013. We now serve

and Read mission and, as a result, are changing the

close to 30,000 children and distribute over 50,000

lives to RI children every day, helping them to arrive at

books each year. We’re celebrating our impact - Since

school prepared to learn and to read. We are grate-

the early years of our program evidence has mounted

ful for our collaborators and community partners who

attesting the effectiveness of our model and now we

share the unquenchable desire to change the sober-

can refer to 16 studies that prove that Reach Out and

ing statistics of low income children in our state. We

Reads can and DOES change outcomes for children.

are grateful to our site sponsors and donors, large and small, who understand the importance of the work we

Here are just a few of the irrefutable facts:

do and show their commitment by supporting this organization and making sure children in RI have books

• Parents served by Reach Out and Read are up to

to call their own, and parents who value reading.

four times more likely to read aloud to their children. For the last several years the team at Performance PICTURED: Michelle Collie reads to children at Providence Community Health Center’s Chafee Health Center, alongside First Lady, Stephanie Chafee.

• During the preschool years, children served by Reach

Physical Therapy have served as adopt-a-site spon-

Out and Read score three to six months ahead of their

sors of the Reach Out and Read program at East Bay

non-Reach Out and Read peers on vocabulary tests.

Community Action Program, in Riverside, and Chafee

These early foundational language skills help start

Health Center in Providence. As a sponsor they are

children on a path of success when they enter school.

helping to ensure the nearly 1,500 children seen at those sites, receive new, developmentally appropriate

Reach Out and Read RI Turns Fifteen in 2014...

• Participating children enter kindergarten better pre-

books at each well-child visit, and their parents receive

pared to succeed, with larger vocabularies and stron-

reading aloud advice from a most trusted source, their

ger language skills.

pediatrician. We are so grateful to Performance Physical Therapy for being vital contributors to the Reach

Reach Out and Read has both the access and the op-

Out and Read mission. Together we’re looking forward

portunity to impact the lives of children at their most

to a bright future full of young Rhode Island readers!

critical point in development, in the first five years of life, and to set them on a path towards success in

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Care at Its Best

continued...

On April 23rd, 2014, Rhode Island’s First Lady, Stephanie Chafee recognized Chafee Health Center and Performance Physical Therapy, whom sponsor Reach Out and Read at the facility, for their outstanding partnership. “Raising three children and working as a nurse with uninsured families, I understand all too well the importance of reading regularly to children and intervening early in the lives of all children to set them on a

Got Pain?

path to success. Reach Out and Read is a proven-effective means of helping prepare children, especially those from low-income households, for success in school,” said Chafee. “I commend Performance Physical Therapy and Chafee

Dry Needling May Be The Answer!

Health Center for making an invaluable investment in the children of Providence, and creating a model for other communities across our state and nation.”

PICTURED: CEO of Providence Community Health Centers Merrill Thomas, Michelle Collie, First Lady Stephanie Chafee, Rep. Joe Almeida of Providence, and Executive Director of Reach Out and Read, Rhode Island, Susanna Beckwith.

Photo: Dave Pavao DPT, CSCS, OCS treats a patients utilizing dry needling.

he vast majority of patients seek medical care for one reason: pain! The source of pain can be complex, arising from joints, muscles, ligaments and tendons. Sometimes pain is described as dull and achy, and other times it is sharp and shooting. Sometimes it stays put, sometimes it spreads. Often the source of the pain is known—arthritis, surgeries, or sprains and strains. But another, often overlooked source of pain responsible for a surprising number of doctor visits is myofascial trigger points. Myofascial trigger points are a common source of pain in patients presenting to primary care, physical therapy, and pain clinics. These hyperirritable spots in muscle are associated with hypersensitive palpable nodules and taught bands. They are painful upon compression and can lead to referred pain and tenderness. The trigger points can also cause muscle and joint pain and restricted, painful motion. When provoked, the tender points may even give rise to autonomic symptoms, like sweating and dizziness. These trigger points can be overlooked as a source of symptoms because they often overlap the pain patterns of other pain-generating tissues

in our bodies, such as joint pain responsible for achy knees or sciatic nerve pain. Myofascial trigger points can affect any part of the body and can develop in several different ways. They commonly develop in response to chronic muscle overload or a repetitive injury, such as poor posture or repetitive work activities. They can also occur very suddenly, after an injury or trauma such as a car accident or sports injury. Common conditions associated with myofascial trigger points include tension-type headaches, chronic neck and back pain, TMJ, and myofascial pain syndrome. Traditional treatments for myofascial trigger points include stretching, massage or other manual therapies, as well as modalities such as heat and ice, or even magnetic fields. Those who don’t have success with these treatments will often undergo trigger point injection from a physician specializing in pain management. For those with pain and limitation caused by myofascial pain and trigger points, there is now a new treatment strategy called trigger point dry needling (TDN). continued...

• DRY N EED L I N G •

• DRY NEEDLI NG • What do you normally do for exercise?

Trigger point dry needling is a procedure that uses an acupuncture-like needle inserted into the skin at the site of trigger points. The goal is to ‘deactivate’ the painful knot and normalize the soft tissue. TDN gets its name because it does not involve any injection of a “wet” substance. As trigger point dry needling has become more common, the evidence for it has grown. Some of the strongest evidence of its effectiveness now exists for some of the most common and frustrating diagnoses, including plantar fasciitis, neck pain, chronic headaches, and TMJ. Yvonne Swanson MSPT, OCS, a physical therapist and orthopedic board certified clinical specialist with fifteen years of experience treating patients states, “Dry needling has had a huge impact on my treatment of patients with both acute and chronic soft tissue injuries. This is the most effective technique I’ve used to resolve trigger points and pain quickly to enable patients to regain movement and get back to work, sports, and life.” The application of trigger point dry needling depends upon the physical examination and assessment of the neuromuscular system to guide treatment. Locating trigger points to place the needle is founded upon knowledge of neuroanatomy and a thorough physical examination. A typical treatment of dry needling from a physical therapist would first begin with a full history to understand your symp-

toms and goals for treatment, followed by a physical examination to see your movement patterns and limitations. Your physical therapist will not only palpate trigger points to locate pain, but to see if they reproduce that familiar pattern of symptoms that led you to seek treatment. Dry needling will typically be used in conjunction with other treatments, such as manual therapy techniques like joint mobilization and stretching performed by your physical therapist, as well as exercises prescribed specifically to reinforce the gains you make during treatment. More than one treatment may be required to reach your maximum potential and to correct the movement patterns or work habits that may have contributed to these symptoms. References: 1. Cummings TM, White AR. Needling therapies in the management of myofascial trigger point pain: a systematic review. Arch Phys Med Rehabil. 82: 986-992; 2001. 2. Kietrys DM, Palombaro KM, Azzaretto E, et al. Effectiveness of dry needling: A systematic review and meta-analysis. J Ortho Sports Phys Ther. 43(9): 620-634:2013. 3. Gonzalez-Iglesias J, Cleland JA, Neto F, et al. Mobilization with movement, thoracic spine manipulation, and dry needling for the management of temporomandibular disorder: A prospective case series. Physiother Theory Pract. 1-10.2013.

Dave Pavao DPT, CSCS, OCS is a Clinic Director and the Director of Clinical Standards at Performance Physical Therapy. He is a clinic instructor at the University of Rhode Island and is a mentor and instructor for Brown University Residents as they complete affiliations at Performance. Dave is certified in dry needling and specializes in the spine, sports injuries, post surgical and vestibular rehabilitation. He can be reached at dpavao@performanceptri.com.

My normal day-to-day workout routine is yoga — and lots of it.

Which recreational activities do you enjoy doing? I have been a mountain bike enthusiast for the last 20 years or so, and I also enjoy kayaking and technical climbing.

Do you have advice for people who say they “don’t have time to exercise?”

“I strongly endorse the physical therapy technique, Dry Needling. As far as physical therapy techniques go, I have tried many. Being in my mid-40s and having played and worked hard in my life, I have experienced both sports and repetitive injuries associated with the construction trade. Dry Needling has provided me with the fastest injury turnaround in my experience. Dry Needling is similar to acupuncture— you will experience both painful and pleasant sensations. And this technique requires you to take time to recover. It is important to note that Dry Needling is administered by a physical therapy specialist who is fluent in many different forms of physical therapy and they take a cross-discipline, holistic approach to treating an injury”.

When you began at Performance, please describe how your problem was affecting your life. When I started physical therapy, my injury was preventing me from working out and I was suffering moderate to acute pain while working.

How did your life change from the Physical Therapy?

A Dry Needling Success Story... Matthew LaRoche is a sports enthusiast and construction worker who came to Performance Physical Therapy with an injury that prevented him

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Care at Its Best

from working and exercising. He was treated with a combination of functional dry needling, manual therapy and therapeutic exercise.

Since undergoing physical therapy, I have become much more mindful of my body’s alignment and the way I am putting torque on my joints as I work and play.

What accomplishments or goals are you most proud of since beginning with Physical Therapy? I feel very happy to be physically well again. Being able to work and work out in a more physically conscious manner has improved my overall performance and longevity.

Yes, take a yoga class anywhere. Find a style and instructor you like and try to get to class twice a week or so. Or start a daily yoga practice at home. There are many excellent free online yoga sites. Ekhart yoga is my personal favorite. Yoga is easily the most effective and accessible physical exercise available for all ages. Try to work out at least five days a week. You will feel physically, mentally and spiritually stronger.

Do you have any advice for people living in pain? Some pain is normal, but acute pain is no fun. I encourage you to seek help for acute pain. Otherwise, pay attention to your body and be willing to change the way you perform certain tasks.

What are your health and fitness goals for the year ahead? In the next three months or so, I would like to be able to do a variation of crow posture with either leg extended, and flexed. I am also planning a mountain biking excursion to see Schermerhorn Gorge in the Berkshires.

How do you stay healthy? I pay attention to my diet and regularly exercise.

Do you have a favorite song to listen to when exercising? Not really. In the winter when I’m on my bicycle trainer, I enjoy listening to lectures and documentaries on YouTube.

What is your favorite post-exercise snack or meal? I enjoy sautéed vegetables, particularly fresh tomatoes, onions and kale with fresh mozzarella over rice or pasta drenched with olive oil.

If you could possess one super-human power, what would it be? Time travel.

• RUNNI NG •

First Printed in RIFit, Issue 1

Running... Running With a Group . . . . . . . . . . . 20 Girls On The Run. . . . . . . . . . . . . . .22 Running For Good. . . . . . . . . . . . . . 24 Running In The Community. . . . . . . . 25 Runner Profiles . . . . . . . . . . . . . 26-28 A Performance Running Analysis . . . 29

KEEPING YOU ON PACE...

Michelle Collie PT, DPT, MS, OCS

am headed home from work, after picking up the kids on a Mid-January afternoon in New England, and I am longing for my sheepskin slippers, cozy clothing and the warmth of a fire. The sun shines only a few hours in the middle of the day, and the ground is covered with snow and ice. It’s easy to see why winter brings only a few of the most dedicated runners outdoors to exercise. I admit to being one of the zealous runners who actually appreciates the challenges of New England’s seasons. I lace up my running shoes and head out in rain, gale force winds, high humidity or snow. I actually enjoy the anticipation of what Mother Nature will offer. In colder temperatures, I see fewer solo runners like myself. I enjoy the peace and solitude of running alone. I like to use

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Care at Its Best

the time to escape the day, get lost in my thoughts listen to music or dream about and plan for the future. But in these shorter winter days, when the temperature rarely breaks 20 degrees Fahrenheit, I long to join the group of women I see running together in hats and gloves. I envy the young college students who venture out in shorts, despite the temperature. I’ve noticed that runners willing to brave the frigid temperatures often do so in a group. Sometimes, there are large groups of 10, or simply 2 people running together. Some are focused on running at a fast pace or are training for a specific event while others are jogging recreationally, talking and enjoying each other’s company. No matter the size of the group or the goal of the run, these runners all look peaceful and content.

Why do people run together? Whether your goal is to run a local 5K or your first marathon, to lose weight or to simply get in the recommended amount of exercise per week, there are a number of reasons why running with others is an effective strategy to ensure you are successful. Group runners keep each other accountable. No excuses. Group running also motivates individuals to keep going, and to increase speed and distance. Brian Hay of Providence just completed the JFK 50 mile ultra-marathon. “When running the JFK 50,” Brian says, “ it was critical to run with a group. Running is as much mental as it is physical, and having a group to motivate, strategize with and provide distractions allowed me to push through the difficult times.” continued...

• RUNNING •

• RUNNI NG • all fighting the same battle.

Running in a group provides some healthy competition as well camaraderie. Dr. Jeff Wilson, a local run-

RI Fit RIMagazine

FIT

ner from Edgewood, RI says, “Running with a group means shared motivation. No one in the group wants to be the one who ‘wimped out’ when the others are

FITNESS HEALTH WELLNESS

bragging that they ran in sub-zero weather!” Wilson’s Saturday morning running group is made up of a group of local friends who call themselves the Mamas and the Papas. “Understanding the drive to run, knowing that our time doesn’t (but does!) matter,

RI FIT MAGAZINE IN PRINT AND ONLINE

and of course those crazy conversations that happen at mile 15 on Saturdays are why we do it.” Jeff says. “ My running group keeps me honest, tired and happy!” RI

Despite the fact that many runners (like me) enjoy the solitude of running alone, there are great benefits to joining others. Whether it’s a formal running club or simply joining a friend to run once a week, it’s

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“I just ran my first 5k, after finishing the Beginning Runner Program led by Hunter, Beth and Bobby. I don’t have the words to express how invaluable their support, encouragement and advice were to me. 11 weeks ago, I could barely run for

gym. We encourage everyone to find a group to join and hit the Rhode!

Wednesday and Sunday Group Runs... Along with our beginning group runs, we encourage all levels to join us for our Wednesday and Sunday group runs. Through the years, we have watched our Wednesday Group runs grow and grow and we now get 30 people regularly and hundreds at our monthly Blackstone Boulevard 5k. It is so motivating and helpful to know you have to meet someone for a run/ walk or even just a workout at the

First time 5k’er with Irish Olympian Alistar Cragg

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Rhode Runner Inc. 657 North Main St. Providence, RI 02904 T.401-831-6346 E.Staff@rhoderunner.net

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worth try — especially if you’ve found yourself think-

Along with the group camaraderie it helps to have a little guidance in your training. We’ve created a 9-12 week training program that will get folks across the finish line of their first 5k. Our USATF certified coaches are there to guide, give advice and keep you motivated throughout the training program.

60 seconds, and I mean barely, and today I crossed the finish line. Thanks again for helping me believe I could accomplish something I never thought possible.”

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Running With a Group T

he first step is always the hardest. This is true whether you are going for a run, a walk or heading to the gym. We at Rhode Runner have always tried to convey the importance of finding a group to join. We have been hosting group runs, group classes and training programs that help foster camaraderie. The main goal is to get you out the door and across the finish line. Our experiences with these groups have been nothing but positive and below you’ll find some examples.

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Care at Its Best

Our Wednesday Night Group Run - Nightlife Run

Beginning Running Program One of our favorite programs is our Beginning Running Program and our Sofa to 5k program with Care New England. We have seen so many people finish their first 5k and we can’t help but smile. After speaking to our customers who take part in the program, they credit the group with their success. Our coaches are some of the best, do not get me wrong, but most of our runners found their motivation in not let-

At Rhode Runner we are devoted to keeping you running and walking in the greatest comfort possible. ting the group down. Our beginning runners were drawn to the group environment because it was fun, informative and they were surrounded by folks

We take the guessing out of shoe buying by providing guidance based on your biomechanics. Hit the Rhode Running! www.rhoderunner.net - 657 North Main St. Providence, RI - 401.831.6346

Share the Rhode with a Runner!

ing, ‘It’s just too cold to run’.

When bombs exploded at the 2013 Boston Marathon, Kim Greene was stopped 0.4 miles short of the finish line. As she struggled to deal with the immediate aftermath and long-term effects of that horrific event, several things helped her to find a reason to smile and rediscover her passion for running – being a coach was one of them.

RUNNING WITH PURPOSE

t all started with a notebook back in 2010.

Kim Greene of Norton, Massachusetts was looking for a place to record her thoughts and doodles. Fortunately, the notebook she ended up buying from CVS piqued her curiosity about Girls on the Run. “When I noticed the Girls on the Run logo and mission on the back of the notebook, I thought ‘That sounds great! I wonder if they’re in Rhode Island.” That’s when Kim, mom and avid runner, started poking around. The rest, as they say, is history – Kim is now the program’s longestserving coach in Rhode Island and credits Girls on the Run with getting her through a very difficult period of her own life.

lum that creatively integrates running. The Rhode Island council, one of over 200 independent chapters across North America, was founded in 2011 and has since served nearly 300 girls ages 8 to 13. This spring alone, the council will offer programming in 10 cities and towns throughout the Ocean State. Four years after her serendipitous notebook purchase, Kim is now a self-proclaimed Girls on the Run RI (GOTRRI) junkie. “I love being part of something that teaches girls how to make healthy life choices. We show them there are lots of different ways to be a girl. Running is just

a vehicle. Girls on the Run is about empowering girls to respect themselves and others, to give back to their community” And Coach Kim is a powerful example of just that. “At the end of last season, I started to wonder how I could help grow and achieve the Girls on the Run mission in a bigger way. We tell the girls to keep moving forward. I want that for myself, too. I want to keep growing. So I asked, what’s next?” Her answer: honor her experience and run with purpose.

“I have coached all four seasons of this amazing program and witnessed firsthand how it prepares girls for a lifetime of self-respect, community involvement and healthy living. The program also impacts adults,” Kim said. “In my case, it helped me through a very dark time last April. During our first practice after the Boston Marathon, we were working through lessons on gratitude and effective communication, but I struggled for words. The girls listened to my story, shared their own stories of the people they knew who were affected by that tragic event. We ended the lesson with a special ‘energy award’ and group hug; the positive energy from that practice helped me to begin dealing with the after-effects of the marathon bombing in a healthy way.”

“I found a way to be useful and engaged; to do something meaningful,” Kim remarks. “We’re incredibly grateful for Kim’s dedication to Girls on the Run RI, and her powerful story demonstrates how meaningful the program is for both the girls and adults involved” explains executive director Michelle Duso. “She is an inspiring example of what Girls on the Run is all about: active, caring girls learning confidence through accomplishment.” To learn more about Girls on the Run RI, to register a girl for programming or to become a SoleMate, visit Girls on the Run RI at www.gotrri.org or on Facebook.

Kim is now training for her 5th consecutive Boston Marathon and this year, she will be running as a Girls on the Run SoleMate. SoleMates are men and women who pursue personal goals – such as running a marathon, 5k, or triathlon - while raising much-needed funds for Girls on the Run. Pictured: Coach Kim and her Team

Girls on the Run inspires girls to be joyful, healthy and confident using a fun, experienced-based curricu-

During sleep, the body is supposed to rest, recover, recuperate and prepare for the next day. For many people this does not happen and they awaken tired, irritated, on edge and in worse shape than the day before. Often, a restless night of sleep is the result of an unsupportive pillow. Clearly, you need to get a good night’s sleep every night. Kim Greene an avid runner from Norton Massachusetts

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Care at Its Best

Try the Mediflow® WaterBase™ Pillow.

• RUNNING •

Running for Good

running in the community

RONALD MCDONALD HOUSE WOMEN’S CLASSIC 5K

he Annual Ronald McDonald House Women’s Classic was held on October 6th, 2013 at the Brown University Stadium on the East Side of Providence. Now in its sixth year, this all-women’s race which is organized by volunteers for the Ronald McDonald House Running Club has become a fixture on the local race calendar. This year, approximately 300 women either ran the 5K or walked the 3K, and gaggles of children ran shorter races on the track. And they all had good reason to run – all proceeds from this race, which totaled $39,000 this year, go back to the Ronald McDonald House of Providence to help fund the services they provide. Since its inception in 1989, the Ronald McDonald House of Providence (RMHP) has provided support for

1. PawSox 5K. Brian Hay MSPT, DPT, OCS and Andrew Horton DPT, CSCS provide participants on-sight assessments at the PawSox 5K. 2. PawSox 5K Award. Kimberley ChulaMaguire DPT receives her medal for her finish in the PawSox 5K. Kim is Performances fastest runner at the 5K distance with a personal record of 18.32sec.

families of hospitalized children. This allows families to spend additional time with a sick child, help ease financial burdens, provide a sense of normalcy and keep families together during times of medical crisis. The house does this by offering 18 guest rooms and dinner for the families of sick children staying at nearby hospitals. The truly remarkable aspect of this service is that the house is run entirely on donated funds. Performance Physical Therapy was proud to be an integral part of supporting the RMHP this year by being a sponsor of the Women’s Classic. Performance was also honored to host a dynamic warm-up for both the kids and adults races. Brian Hay, a physical therapist at Performance, was in fine form as he led dozens

of women and children through the warm-up. In addition Brian, along with colleague and physical therapist Andrew Horton, offered free injury screens and advice to runners. Though the day was overcast and cool, exercise, fun and smiles warmed everyone. Hundreds of participants in the race walked away with raffle prizes, as close to 200 prizes were donated to the race by the members of the running club. For Brittany DiSciullo, this was a road racing debut. “It was my first race and it made me want to do more! It was a great experience and everyone there was so supportive. I will be back next year.”

4. Barrington Firefighters Memorial 5K. Jenn Reynolds DPT and Lisa DeCoste MSPT, DPT, OCS led the warm up at the 2013, Barrington Firefighters Memorial Day 5K Charity Road Race.

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9. Color Me Rad 5K. The North Providence team at the Color Me Rad 5K. Pictured, Zack Traskauskas, Kelly Aziz, Molly Smith DPT, Jaimie Fellela PTA and Lisa Fellela.

serves on the executive council for the Ronald McDonald running club and has also been involved in organizing the Women’s Classic Road Race. Kim specializes in sports injuries, orthopedics and running injuries. She is certified in dry needling. Kim can be reached at kchulmaguire@performanceptri.com.

Care at Its Best

6. 2013 Arthritis Walk. The Performance team at the 2013 Arthritis Walk. Pictured, Adam Ware CSCS, BS, Andrew Horton DPT, CSCS, Megan Schwartz DPT, Carolyn Tomasello DPT, Melissa Robidoux DPT and Brian Hay DPT, MS, OCS.

8. Pinelands 50K Mud Run. Michelle Collie DPT, PT, MS, OCS, Jared Constable MSPT, Jessica Hay CNPN-AC and Brian Hay MSPT, DPT, OCS celebrate completing the Pinelands 50K Run, despite the mud!

Kim Chula-Maguire is a physical therapist at the Performance Physical Therapy, Pawtucket clinic. Kim

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5. Barrington Firefighters Memorial 5K. Lisa DeCoste MSPT, DPT, CSCS, Jenn Reynolds DPT, Nick Valletta, Chris Hughes and Hunter Hughes at the Barrington Firefighters 5K Charity Road Race.

7. St. Pat’s 5K. The Performance team at the St. Pat’s 5K held in downtown Providence.

Photo Top: Brian Hay MSPT, DPT, OCS, Nick Valletta and Chris Hughes with the NIROPE team! Photo Left: Kim Chula-Maguire (second from right) placed 4th in the Women’s Classic 5K.

3. GOTR 5K. Brian Hay DPT, MS, OCS was a running buddy at the 2013 Girls on the Run 5K held at Roger Williams Park.

10. Holiday Spirit. Keeping the running spirit alive through the holidays!

• RUNNING •

• RUNNI NG •

The Man Who Did Not Give Up

Goal Setting Proves Effective For Fitness

Local physician Dr Jeff Wilson provides his inspirational story. He was determined to run a marathon despite ongoing injuries, and finally did it!

Fran Parisi did more than what he initially set out to do. An initial goal to lose weight and complete his first 5K successfully evolved into future goals of running at least one marathon per year.

What brought you to Performance? I came to Performance for knee tendonitis and shin splints that started when I was training for my first marathon in 2010. PPT helped me recover but my time off from running caused me to miss the race. I was followed by Performance on and off for most of the next year and was again sidelined in the fall with the same injury due to overtraining. In 2012, I tore my ACL and had surgery in July, keeping me from completing the marathon for a third time. After surgery, I started therapy twice weekly for the next 6 months and was back running by December. With the support and guidance from the team at Performance, not only did I rehab my ACL but finally ran my first marathon in October 2013! What do you normally do for exercise? Running is my cardio exercise of choice despite the fact that my mechanics would probably prefer something with less pounding – physical therapy has helped me improve my mechanics, focus on core strength and to give me the confidence to keep exercising the way I want.

relaxes me and on days that I have to miss a workout, I can feel the stress. What is your favorite post-exercise snack or meal? My favorite post exercise food is chocolate soy milk – sugar, chocolate and big protein to help replenish things—and maybe an everything bagel with jelly!

“Turning 49 in late 2010, I stepped on a scale and saw numbers I had never seen before (actually, I couldn’t really see them over my stomach). Over the next year, I went on a mission to lose 50 pounds by eating better and exercising more. Even though I had never run a mile in my life before, I started running, with the goal of completing a neighborhood 5K.” What brought you to Physical Therapy? As I started running more and more, I developed a relatively normal issue for runners: a bruised navicular bone in my foot. A running coach friend of mine recommended physical therapy. How did your life change from the Physical Therapy? When I started developing foot issues, I was scared that I wasn’t going to be able to keep running and training, an activity that had become my primary source of exercise (and stress relief). Performance Physical Therapy never once told me to stop running. They massaged my foot and taught me how to warm up and stretch and definitely helped the problem resolve itself. I later developed plantar

What are your health and fitness goals for the year ahead? In the next year, I would like to train for another marathon run short distances faster and keep trying to look and feel younger than my age!

What do you normally do for exercise and recreation? I run several days a week. I swim one day a week and I work out in the gym one or two days a week. In addition to running, I ski several days each winter, I bike multiple days every summer and I do at least one major (multiday) hike every year. Do you have advice for people who say they ‘don’t have time to exercise’? 1. Prioritize it. 2. Keep a log. 3. Set a goal: “I want to lose ____ pounds.” 4. Exercise with people (not only does it make the time go by faster, but the commitment of meeting people is very motivating).

Is there fitness device or gadget that you can’t live without? I have an app for my phone called “Map My Run” that keeps track my workouts and mileage. How do you stay healthy? Eat smart: everyone knows the rules; the challenge is to follow them. And exercise. Regularly. Do you have a favorite song to listen to when exercising? My son is in a band Northeast Traffic. I have listened to their album probably 200 times as I run.

What is your favorite time of day to exercise? I tend to like working out in the morning. Usually I get up at 5am and by 530am I am either running, doing an elliptical on off running days or working out with my TRX. Working out

If you could possess one super-human power, what would it be? Endurance. I want to run forever. Fran Parisi enjoys Chicago after successfully completing the marathon

Care at Its Best

What accomplishments or goals are you most proud of since having Physical Therapy? Within 18 months of my 49th birthday, I had run several 5Ks and 5 half marathons. In April 2012, I ran the Boston Marathon, in September 2012 I completed a triathlon and in October 2013, I ran the Chicago Marathon. I am still running, and plan on running one if not two marathons this year.

Do you have any advice for people living in pain? There is no reason to live in pain. Get it fixed. Physical Therapy does help, if you do what you are supposed to do.

Is there fitness device or gadget that you can’t live without? I love my Garmin – GPS info at its best! I also recently got a heart rate monitor and although it has taken time to get used to wearing the strap around my chest, I really like following my heart rate with respect to training. I also have a TRX that has become my bread and butter workout because it targets muscle groups, core and even provides cardio.

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fasciitis, and again, I never needed to stop running, but I was helped and treated with a combination of techniques.

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• RUNNI NG •

A Journey from Debilitating Migraines to Running 5K’s Cheryl Jerominek, a registered nurse in the Neonatal Intensive Care Unit at Women and Infants Hospital, life has changed! In October of 2012 she was hospitalized due to “the worst migraine ever.” She had been suffering with migraines for many years, but never this bad. She started physical therapy and started feeling better immediately. With this new found relief from chronic pain Cheryl was motivated to make other changes in her life. Cheryl worked with her Physical Therapist, Kim Chula-Maguire, an avid runner, who suggested she start running. Cheryl states, “I was never a runner, never considered running, didn’t think I could since I was 100 lbs overweight and severely unfit.” However, with the guidance of Kim, Cheryl began with a walking program and soon advanced to a “Couch to 5K” program using her Fitness Pal app. Fast forward to May 2013 and Cheryl ran her first 5K! Cheryl reports, “The day of the race, the most incredible thing happened. My PT ran the race with me. With her help, both mentally cheering me on and physically teaching me better form and breathing techniques I completed the race in 40:36.”

What are your health and fitness goals for the year ahead? I would like to continue with my weight loss and run a 10K. What is your favorite time of day to exercise? Mornings –I am a “get up and go” person. Exercising in the morning sets me up mentally and physically to have a productive day. What is your favorite post-exercise snack or meal? I love salad with greens, multiple types of beans, chicken, goat cheese and quinoa. Which sports teams do you cheer for? I love the Boston Red Sox and New England Patriots. If you could possess one super-human power, what would it be? Since I’ve been a nurse for 25 years my first answer would be the power to heal with the touch of a hand. The second would be to beat my physical therapist, Kim ChulaMaguire in a race. I tell her all the time that she is a cheetah and I am a snail!

What brought you to Performance? My physician recommended physical therapy as it was believed the migraines I was suffering may be due to neck problems since I often experienced neck and shoulder pain. The migraines affected my life negatively as when they occurred I was unable to function. I would have to lie down in a dark room for hours. I could not work nor take care of my son. Once I started physical therapy the migraines went away. I would occasionally have a headache but it never turned into a migraine. What accomplishments or goals are you most proud of since having Physical Therapy? Since January of 2012 I have lost 60 lbs and have completed four 5K races. What do you normally do for exercise? Since starting physical therapy, I began walking, jogging, spinning – I am a spin addict! Plus TRX, kettlebell and core exercises. Do you have any advice for people living in pain? Living in pain saps so much joy out of life. Try to do something to alleviate the pain as much as possible and exercise to help you feel better. Cheryl Jerominek with Physical Therapist, Kim Chula-Maguire, DPT.

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Care at Its Best

It’s Time for a Performance Running Analysis By Brian Hay MSPT, DPT, OCS

t starts with technique. Every activity we do requires a particular technique. Whether it is lifting a box, shooting a basketball, downhill skiing, or swinging a golf club, form and technique are essential to produce the best results and stay healthy. Running is no different. For some people good running form may come naturally, but for the majority of runners, particularly recreational runners, it does not come naturally. Good form is a learned process that requires training and practice. When thinking about running we should have one thing in mind, “efficiency.” Being efficient is an important part of running and staying injury free. There are many different training programs and buzz words out there such as Chi Running, Pose Method, Minimalist Running, and Barefoot Running. As a physical therapist I frequently get asked, “what is the best approach?” Research shows that there is no definitive answer to that question. However, behind all those styles are some core principles that make someone a strong and healthy runner. Those principles relate to stride and having good form. The best way to improve your form is to have it analyzed by a trained professional. Performance Physical Therapy offers the Performance Runner’s Analysis, a comprehensive screen that includes a video assessment and a movement and strength screen designed to identify muscle imbalances that put you at risk for an injury. This is followed with recommendations on exercises and techniques to improve your running.

If you are returning to running after a running injury, wanting to be proactive and prevent having an injury, or just looking to improve your running, a Performance Running Analysis is a great investment in your running future.

Components of a Running Analysis...

• FIGURE 1 • 1) The amount of vertical displacement a runner has. Vertical displacement is a huge energy waste. The body is using energy to move up and down rather than forward. 2) The point where heel strike occurs in relation to midline. This can often indicate hip weakness that can result in increased stress on the hip, knee, and ankle. 3) The amount of pronation that occurs during foot strike. Some pronation is normal, but too much can be a sign of ankle instability and can result in injuries like a stress fracture. • FIGURE 2 • 1) The amount of vertical displacement. 2) The amount of knee extension or straightening that occurs prior to impact. Too much knee extension does not allow the muscles to act as a shock absorber and creates a large amount of unneeded stress on the joints. 3) Arm swing. An effective arm swing can help to propel a runner forward, but an ineffective arm swing can result in excessive trunk rotation creating back and hip problems. Not to mention it can be extremely inefficient. 4) Foot Strike. At what point does the foot contact the ground? Ground

contact is one of the keys to staying a healthy runner. Where you contact the ground determines how the impact is dispersed through your body. The less impact the healthier the joints. 5) Cadence. How many times does your foot contact the ground in a minute? Fixing cadence can often fix many stride problems that result in injuries. For more information on the Performance Running Program please visit www.performanceptri.com/running.html

FIGURE 1

FIGURE 2

• WOM EN’S H EA LTH •

HERE ARE FOUR EXERCISES TO START WITH: Pelvic Floor Contraction (Kegels): Tighten the muscles around your vagina. The muscles you use to stop the flow of urine. Hold for up to 10 seconds, release for 10 seconds. Repeat 3 times throughout your day.

Returning to Pre-Pregnancy Shape By Jennifer Reynolds, PT DPT

eturning to exercise after pregnancy can be

When to Start

challenging but it essential in returning to pre-

In the past, health care providers often instructed women to wait at least six weeks after giving birth to begin exercising. The waiting game may be over, however. If you exercised during pregnancy and had an uncomplicated vaginal delivery, it’s generally safe to begin exercising within days of delivery — or as soon as you feel ready. If you had a C-section, extensive vaginal repair or a complicated birth, talk to your health care provider about when to start an exercise program.

pregnancy fitness and strength. Proper strengthening will help avoid low back and hip injuries that can be common in the postpartum period. Some other benefits of regular exercise after pregnancy are: • Promote weight loss • Improve your cardiovascular fitness • Restore muscle strength • Condition your abdominal muscles • Boost your energy level • Improve your mood • Relieve stress • Help prevent and promote recovery from postpartum depression

How to Start It is important to train and strengthen your abdominals and pelvic floor after pregnancy in order to avoid injury to your low back, pelvis and hips. Strengthening the abdominals and pelvic floor will also help maintain urinary continence.

Transverse Abdominis Contractions: This muscle is the deepest abdominal muscle as works like a corset to stabilize your low back and pelvis. It will also help return your abdominals to pre-pregnancy shape and reduce the postpartum belly. Lay on your back with knees bent. Take a deep breath in through your nose and exhale through your mouth. As you exhale pull your belly button down to your spine. Hold for 10 seconds, repeat 10 times. Diastasi Recti Correction: Pregnancy can cause the abdominal muscles to separate. Separation of the abdominals causes decreased stabilization of the pelvis and low back as well as contributing to incontinence. To correct the separation lay on your back with knees bent. Place your hands criss-crossed across your abdomen. Perform a small neck and shoulder lift. As you lift pull your hands together bringing your abdominal muscles together. Hold for 10 seconds. Repeat 10 times, perform 3 sets. Bridge Exercise: Lay on your back with knees bent and feet flat. Tighten your abdominals and gluteals and lift your hips up toward the ceiling. Hold for up to 10 seconds, keep everything tight as you lower your hips down. Repeat 10 times, perform 2 sets.

DIASTASI RECTI CORRECTION

BRIDGE EXERCISE

If you need help or guidance Performance Physical Therapy can help! Musculoskeletal pain after pregnancy is not normal. If you are experiencing low back pain, upper back/neck pain, hip pain, pelvic pain, vaginal pain or trouble controlling your urine speak to your health care provider and contact Performance Physical Therapy.

To learn more about the women’s health services at Performance please visit: www.performanceptri.com/womenshealth.html

Jennifer Reynolds, PT, DPT Jennifer received her Doctor of Physical Therapy from the University of Illinois, Chicago in 2006 and has continued training with the APTA women’s health section in pelvic floor rehabilitation and treatment of the pregnant patient. Jennifer came to Rhode Island from Chicago where she worked and trained with the acclaimed NorthWestern Memorial Physician Group OB/GYN. Jennifer provides women’s wellness presentations and lectures in the community on topics such as pelvic floor pain and pregnancy related issues. Jen can be reached at jreynolds@performanceptri.com Photo: Jennifer Reynolds, PT, DPT educates a patient on the changes occurring to a women’s body during pregnancy.

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• PR OGRAMS •

• PROG RAMS •

Stay Fit 4 Life: The Performance Gym Program Upon completing a course of physical therapy treatment, Performance welcomes the ongoing use of our facilities. Continue to exercise in the atmosphere you are comfortable with and remain in contact with your Physical Therapist who knows your body better than the staff at another gym. Program includes monthly fitness screenings and ongoing assistance to challenge you and ensure the program is fun! Photo: Megan Marcello MSPT, OCS assesses changes in agility and speed

Oncology Massage Therapy

Performance offers specialized services for cancer survivors. There are a growing number of survivors in the United States and most survivors experience

Massage is an effective treatment for reducing stress, anxiety,

a decline in their quality of life due to the debilitating

muscle tension and pain due to injuries, conditions or overuse.

side effects of toxic treatments. Another concern

Regular massage can optimize health by improving sleep and

for cancer survivors is their decreased cardiovascu-

digestion, managing stress and eliminating muscle tension. Per-

lar health.

formance offers a variety of types of massage therapy including; • Swedish massage. A gentle form of massage that uses long

Cancer survivors benefit from physical therapy to

strokes, kneading, deep circular movements, vibration and tap-

address pain, fatigue and limited cardiovascular fit-

ping to relax and energize.

ness to improve their overall quality of life.

• Deep massage. Targets the deeper layers of muscle and connective tissue, commonly to help with muscle damage from injuries. • Sports massage. Specifically geared to treat and prevent sports injuries. • Trigger point massage. Focuses on areas of tight muscle fibers that form in muscles after injuries or overused. • Shiatsu. A Japanese technique promoting relaxation, reduction of stress and pain. • Reflexology. Application of pressure to specific points and areas on the feet, hands, or ears that effect areas of the body. • Cupping. Through suction and negative pressure, massage cupping releases soft tissue, drains excess fluids and toxins, loosens adhesions and lifts connective tissue bringing increased blood flow to skin and muscles. Massage therapy services are offered by certified massage therapists. Gift Certificates are available.

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Kara Sousa, MSPT is a STAR® clinician at Performance Physical Therapy. Kara became a certified clinician through comprehensive coursework to provide expert rehabilitation services to cancer survivors. The STAR® Certification program (Survivorship Training and Rehabilitation) was developed by Oncology Rehab Partners and is considered to be the gold standard in cancer rehabilitation. Kara’s STAR® certification enables her to utilize evidence based research to provide superior clinical services to cancer survivors at any stage of the disease. Kara became interested in becoming a STAR® Clinician after her own personal battle with breast cancer in 2010. Kara’s year long journey with breast cancer has motivated her to help others recover from cancer. She understands the needs of cancer survivors and is dedicated to helping them. Kara works one on one with cancer survivors in the clinic and together with the survivor, sets realistic, obtainable goals to ensure improved quality of life.

Pediatrics Performance offers care for the pediatric population, for children of all levels of ability. Physical Therapy for the pediatric population focuses on intervention to promote gross motor skills, development and functional mobility. Specific exercises and developmentally appropriate play promote optimal mobility, strength, balance and coordination. A treatment session lasts 30 to 60 minutes and encourages care-giver participation, family education and instruction on a home program to maximize follow through. Physical Therapists communicate and work with the pediatrician and any other health care providers involved in the care, resulting in a team approach to the overall well-being of the children. Photo: Yvonne Swanson MSPT, OCS, works with a young athlete.

Personal Training Whether your goal is to lose weight, improve fitness or be part of a post rehabilitation program to optimize your performance, we have qualified and experienced Physical Trainers available to work with you.

Learn more about the programs Performance Physical Therapy offers at: www.performanceptri.com/programsandservices.html

• PR OGRAMS •

The Performance Movement Screening The Performance Movement Screen is a total body assessment designed to identify weaknesses, flexibility, and mobility problems. The screen benefits those who feel limited with movements during sports, fitness activities or day to day life and for those wanting to maximize performance and minimize their chances of injury.

• PROG RAMS •

Occupational Health Let Us Brighten Your Outlook!

The Performance Movement Screen is tailored by using the Functional Movement Screen (FMS) and the Selective Functional Movement Assessment (SFMA). The FMS and SFMA are currently used by NFL teams, MLB teams, NBA teams, professional golfers, and many other professional sports. The Performance Movement Screen is available as part of a Physical Therapy Evaluation. Photo: Andrew Horton DPT, CSCS performance a movement screen for an athlete during a pre-season screening

Aquatics The Benefits of the Water The water provides a natural traction force that distracts joints (allowing more joint space), which makes movement easier. Body weight is reduced by 90% in the water, which makes for an optimal environment to exercise joints and muscles without the compression caused by our body weight. Aquatic therapy also helps to increase one’s bone density by providing 12 times the resistance of air. The therapeutic benefits of water include pain relief and assistance with the return to prior level of function.

Who Can Benefit? Diagnoses that may benefit from aquatic physical therapy vary considerably, they include such conditions as arthritis, neck and back pain, nerve root compression and fibromyalgia, and inability to tolerate land-based exercise. Post surgical patients often find the water an excellent, gentle way to progressively build range of motion and strength again. Our physical therapists will customize a specific program to restore joint and muscle function. Improve your quality of life by giving aquatic therapy a try!

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For more information, please contact Brian Hay, MSPT, DPT, OCS bhay@performanceptri.com Ph: 401-726-7100

• PR OGRAMS •

• PROG RAMS •

Pilates

Hand Therapy

Ellynn Koelsch MSPT leads the hand program at Perfor-

ilates is a dynamic form of exercise developed by Joseph Pilates that is designed to stretch, strengthen and redevelop the body. This core-conditioning method uses spring resistance for balanced strength and flexibility. Pilates coordinates breathing with challenging exercise to improve posture and body awareness. It’s a fun, intelligent and invigorating way to prevent injuries, get in shape and increase your sense of well-being. The certified Pilates instructors at Performance have the knowledge and ability to customize Pilates sessions to meet your individual fitness goals. Additionally, our physical therapists often incorporate Pilates exercises and the reformer machine into the rehabilitation of patients.

mance Physical Therapy. Ellynn is a member of ASHT (American society of hand therapists) staying current with best practices for the treatment of hands, wrist, elbows and shoulder problems. Ellynn has over 8 years of clinical experience and over 4,000 hours of direct patient involving the shoulder, elbow, wrist and hand.

The hand is a complex and unique part of the human body. Treatment of the hand requires clinicians with a high degree of specialization, experience and advanced certification.

• Arthritis • Carpal Tunnel Syndrome • Tendonitis

What Does Hand Therapy Provide?

• Trigger Finger

• Preventative, Non-operative or conservative treatment of the elbow, wrist and hand

• TFCC Injuries

• Management of acute or chronic pain • Desensitization following nerve injury or trauma

• Sensory re-education after nerve injury

• Elbow, Wrist, and Hand Fractures

• Conditioning prior to returning to work, sport and lifestyle

• Joint Contractures • Elbow Dislocations (pre and post surgical) • Dupuytren’s Disease • Dequervain’s Tenosynovitis • Lateral Epicondylitis/ Tennis Elbow

Common Diagnosis

• Medial Epicondylitis/ Golfer’ Elbow

Patients who need hand therapy may have been affected

• Nerve Injuries/Cubital Tunnel and Radial Nerve Palsy

by an accident or trauma, over-use or disease leaving them with pain, wounds, scars, burns, injured tendons or nerves, fractures, or even amputation, limiting use of the hand.

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Performance offers mat classes as well as private and semi-private sessions utilizing the reformer, tower, ladder barrel, arc barrel and chair.

For more details please call: 401-726-7100 or visit us online at www.performanceptri.com/pilates.html

• Ligament & Tendon Injuries • Crush Injuries

• Training in the performance of daily life skills through adapted methods and equipment

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• Wrist Sprains/Strains

• Custom fabrication of static, static progressive, and dynamic splints • Design and implementation of home exercise programs to increase motion, dexterity, and/or strength

Performance offers Pilates – one of the nation’s fastest growing forms of exercise.

• Nerve Repair • CMC joint arthroplasty • Extensor Tendon Tenolysis

Alice O’Neill, is a Pilates Method Alliance (PMA) Certified Teacher. She completed the Jen McWalters Studio Teacher Training Program in Pawtucket, Rhode Island. Alice has worked with instructors in Australia, New Zealand, and the United Kingdom and worked and practiced at the renowned PilateSpa studio under Kathleen Conklin in Wisconsin.

THE HUNDRED Start by lying down on a mat, Reformer or Cadillac with your knees bent and together. Place your knees over your hips. Stretch your arms long, by your side. Pump your arms up and down as if you were slapping water while breathing in through the nose for 5 counts and out through the mouth for 5 counts. Continue this action for a hundred counts of breath and arm pumps. The goal is to lift the head, neck and shoulders, while maintaining a flat back and “scooped” belly.

SINGLE LEG CIRCLES Lying on a mat, Reformer or Cadillac with one leg up to the ceiling at 90 degrees, slightly externally rotated. Draw a circle with the leg by moving it across the body as you inhale, down and back up to the ceiling as you exhale 5 times and then reverse the direction. Accenting the leg on the way back to the top will give greater emphasis on the stretch. The goal is to circle the leg from the hip, while keeping the body stable on the mat and the leg straight to stretch the hamstring and back. To keep the body completely still on the mat it will be necessary to “scoop” the abdominals.

• L ET’S GET P H YS I CA L •

• LET’S G ET PHYSICAL •

Are Health Problems Stopping You from Enjoying Life?

Let’s Get Physical!

A program designed to increase function and quality of life of individuals with diabetes, obesity, osteoporosis, balance problems, arthritis and many other health conditions. The Let’s Get Physical program is an 8 week, exercise based, one on one program designed to provide participants with the education and tools necessary to live a healthier lifestyle. Did you know that according to the Mayo Clinic, regular exercise has been proven to improve weight loss, improve one’s mood, boost energy, promote better sleep, and combat health conditions and diseases?

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•

Let’s Get Physical is initiated with a personalized evaluation completed by a physical therapist and includes ongoing re-evaluations throughout the program to monitor an individual’s progress.

•

You will be provided with education and a safe progression of exercises designed to address the areas that limit your ability to be as active as you would like. You will obtain a healthier level of fitness that will improve your quality of life.

•

The exercises will be challenging strength, flexibility, and cardiovascular fitness, all while gaining postural awareness, strength, and balance. Education is also provided on nutrition, injury prevention, and general health and wellness.

•

You will complete the program with the knowledge, ability and resources to continue with exercise as part of your life.

Care at Its Best

•

The Let’s Get Physical program is the first step to making lifelong changes that will allow you to live a happier, healthier lifestyle and is covered by most insurances.

The benefits of regular exercise include: • Decreasing high blood pressure • Weight control • Helps to relieve the pain associated with arthritis • Reducing falls among older adults • Reducing the risk of dying from coronary artery disease • Contributing to healthy bones, muscle and joints • Reducing symptoms of anxiety and depression • Having fewer hospitalizations, physician visits and medications.

To begin the Let’s Get Physical program, please call (401)726-7100.

Evaluation includes assessment of vitals, BMI, fitness & function, medical screening, lifestyle and patients goals.

Disease Specific Education & Management

Posture, Body Mechanics and ADL assessment and Education

Graded Progression of Exercise Addressing Areas Limiting Function & Activity

The Performance Solution; Let’s Get Physcial! Diabetes, Obesity, Osteoporosis, Hypertension, Balance Problems, Arthritis

General Nutrition and Healthy Choice Education

Balance Assessment and Fall Prevention

Pain Management Education Weight Bearing, Cardiovasular, Flexibility and Resistive Exercise

• L ET’S GET P H YS I CA L •

• LET’S G ET PHYSICAL •

share and celebrate your achievement.

Five Simple Secrets to Leading a Healthier Life By Jose Polanco, MD, FACP and Nicole Gendron

o you live your life the healthiest way possible? If not, would you like to change that? Change can be a scary thing, but by taking some simple steps, you can easily be on your way to living a healthier life. Each day, Blackstone Valley Community Health Care (BVCHC) encourages patients to take small steps to improve their quality of life. Below are five simple things you can do, so go ahead and challenge yourself to make 2014 your healthiest year yet!

1. EAT RIGHT There is no reason to attempt a crazy diet regimen to make an impact on your eating habits. Instead, make a few, simple changes to the foods you eat. Drink more water. Substitute juice, soda or fitness drinks with water; these drinks tend to have more sugar than you think. Cut out processed foods. Choose to eat fresh produce and meat instead of a pre-packaged meal. Eat less, but more often. Eating five small meals a day will maintain your energy levels and help burn fat faster. Get into a routine. Plan your meals and eat them at the same time each day. Also, keep a food journal to keep track of the food you consume.

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2. MOVE MORE A workout doesn’t have to include lifting weights or running. In fact, many of these high impact activities can be intimidating for those less experienced. Have no fear – there are many other options to get and keep you moving. Take the stairs. Start small – skip the elevator and take the stairs instead. Park far away. It gives you the chance to enjoy some fresh air! Take a hike. The scenery is much better than it is on a treadmill. Ride a bike. Consider ditching the car and commute to work via bicycle.

3. SET GOALS When was the last time you set a goal for yourself? It could be as easy as committing to take the stairs instead

of the elevator. For many reasons, it’s important to set some realistic goals for yourself. It will propel you forward, keep you committed and help you live life to its fullest. Be specific. Include things like action steps and a timeline for your goal – it will help you keep on track! Write them down. Research shows people with written goals accomplish significantly more than those without. Focus on a few. Choose just a few, specific goals instead of trying to take on too much at once. Once you reach one, add a new goal to your list. Review them often. Don’t write them down and forget! Plan to review your goals at least once a week.

4. CREATE A NETWORK It’s always more fun to do something with your friends or family, so why not get them involved in your plan to live a healthier life? Create a support system, with your closest friends and family members, to help you reach your goals. Cook together. It’s always nice to share a meal with someone, so prepare a healthy dish and enjoy! Try a new exercise. It can be intimidating to try something new by yourself, so bring a partner instead. Celebrate your successes. When you reach your goal, join a friend to

5. FIND A DOCTOR It’s hard work to manage your health on your own. That’s why it’s so important to get some help from the experts, your primary care provider (PCP) and care team. Work together. It’s important to choose a PCP you feel comfortable with and then start to build a partnership. This relationship is vital to achieving long term success. Use your resources. Not only will you have a PCP, but chances are you’ll also have access to a network of resources

that will help you achieve your goals. This could include nurses, educators, counselors or more! Ask questions. If you don’t understand something, just ask! Your provider wants to make sure you understand so if you’re unsure, never hesitate to speak up. At Blackstone Valley Community Health Care, we help our patients each day make healthy decisions and encourage them to live a healthier life. It’s never too early to make a change and Blackstone Valley Community Health Care is here to help. Our Med-

ical Director, Dr. Jose Polanco says, “at each visit, I encourage and work with my patients to set self-management goals. This is an easy first step that anyone can do and it will create a healthy change in their lives.” Blackstone Valley Community Health Care can help care for every member of your family with a variety of primary medical, dental, behavioral health and pharmacy services. Call 401-7220081 to learn more and become a patient—and make 2014 your healthiest year yet.

The Benefits of Exercise in Managing Diabetes By Molly Smith, DPT

Background Information There are 25.8 million people in the United States who have diabetes. 18.8 million have been diagnosed, and 7 million people remain undiagnosed. It is estimated that 79 million people are prediabetic (at high risk for development of diabetes)*.

Type 1 “Juvenile Diabetes” (5% of cases) In Type 1 diabetes, the body does not produce insulin—the hormone that converts sugars and other foods into energy for the body to use. Insulin therapy is used to treat people with this condition.

Type II Diabetes (most common) Insulin’s job is to carry sugar

from the blood into the body’s cells. With Type II diabetes, the body is either unable to make enough insulin or it begins to ignore it. The body becomes “insulin resistant.” People with Type II diabetes normally take oral medication(s) and/or insulin.

hormones can block the action of the mother’s insulin’s ability to regulate blood sugar. Treatment of gestational diabetes includes specific meal plans, physical activity, and possibly insulin injections.

Gestational Diabetes Gestational Diabetes occurs in 18% of pregnancies around week 24. A woman can develop high blood sugar levels during her pregnancy, even if she does not have pre-existing problems with her blood sugar. Most of the time, postpregnancy blood sugars return to normal levels. The cause of gestational diabetes is unknown, but the theory is that hormones from the placenta that help the baby grow are involved. These

that exercise is good for us. It can lower blood pressure, cholesterol, and risk for heart disease and stroke. It can improve your quality of life by relieving stress, reducing symptoms of depression, and by helping you sleep better. It also increases your energy for activities of daily living and can help you to lose or maintain your weight. How can exercise help those with diabetes?

Diabetes and Exercise We know

continued...

• L ET’S GET P H YS I CA L •

• Exercise helps lower blood sugar levels. During exercise, muscles activate a mechanism that allows glucose to be taken in by the cells to use for energy without the help of insulin. • When you exercise (and even up to 24 hours after), your cells become more sensitive to insulin and are able to use it more efficiently to remove glucose from the blood. • Exercise can improve a person’s A1C rating. An A1C blood test gives a patient with diabetes an idea of how well they have been controlling their blood glucose levels over the past 2-3 months. • If you have diabetes and you exercise regularly, you may be able to take less insulin or diabetes medications if your A1C rating improves.

• LET’S G ET PHYSICAL •

Here are some important things for diabetic patients to consider: • Monitor your blood glucose before, during and after exercise to learn how exercise affects your blood sugar • Keep a snack with you that has 1520 grams of carbohydrates (see below) in case your blood sugar gets low (hypoglycemia, or an insulin reaction). It is usually considered an insulin reaction if your blood sugar is below 70 mg/dl. • If your blood sugar is below 100 mg/ dl before exercising, have a small carbohydrate snack. Examples include: - Glucose tablets (follow directions on label) - 2 tablespoons of raisins - 1 tablespoon of sugar or honey, hard candies (look at grams of carbohydrates on package) - 8 oz. of orange juice. • Be able to recognize the signs of hypoglycemia, which may include (but are not limited to):

If you think you are experiencing low blood sugar, take the following steps: 1. Consume snack with 15-20 grams of carbohydrates 2. Recheck blood sugar levels after 15 minutes 3. If low blood sugar persists, repeat steps 1 and 2

- Irritability, confusion, impatience - Lightheadedness, dizziness - Rapid, fast heartbeat

Beginning an Exercise Program If you are a patient with diabetes (or any other medical condition), it is important to check with your doctor before beginning an exercise program.

• Hypoglycemia can lead to severe complications and even coma or death so it is important to listen to your body and to monitor your blood sugar closely.

Guidelines for Activity The ADA

If the questions above describes you then A Matter of Balance: Managing Concerns about Falls is a program for you.

recommends doing a form of aerobic exercise for 30 minutes a day, at least 5 days out of the week (i.e. walking, bicycling, swimming). If you are starting exercise for the first time, start off with smaller increments of time. For example, take 2-3 shorter walks throughout the day. Remember to set aside designated time for aerobic exercise during which your heart rate stays elevated. Activities of daily living such as walking to the mailbox or carrying a load of laundry up the stairs are great because they keep your body moving but they are not considered planned exercise. This goal of this article is to inspire and educate those with (or without) diabetes to begin an exercise program. However, remember that it is important to speak with your doctor before starting an exercise program. *These estimates were made using fasting glucose and A1C levels from the 2011 National Diabetes Fact Sheet Source: The American Diabetes Association

dence. A recent graduate from the University of Rhode Island, Molly is passionate about prevention of injuries and disease. She specializes in orthopedics, multiple sclerosis, workplace ergonomics and the spine. Molly can be reached at msmith@performanceptri.com

Care at Its Best

Have you turned down a chance to go out with family or friends because you were concerned about falling? Have you cut down on a favorite activity because you might fall?

Molly Smith DPT, is a physical therapist at the Performance Physical Therapy clinic in North Provi-

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Managing Concerns About Falls

4. Eat a snack once your blood sugars return to normal levels if your next meal is more than 1-2 hours away

- Shakiness, nervousness, anxiety - Sweating, chills

A Matter of Balance:

Did you know that 25 – 50% of independently living older adults have an extreme fear of falling, which is actually linked to a higher risk for falls. Fear of falling can be just as dangerous as falling itself. People who develop this fear often limit their activities, which can result in severe physical weakness, making the risk of falling even greater. Each year, one in three adults over 65 will fall and sustain moderate to severe injuries. In 2010, direct costs to the United States health care system for fall related injuries were over 30 billion dollars. A Matter of Balance classes are provided for free, with the ambition of significantly decreasing this cost due to falls too our health care system. Science tells us that falls do not have to be a natural part of aging. A Matter of Balance: Managing Concerns about Falls is designed to re-

duce the fear of falling and improve the activity levels of older adults who are concerned with falls. Developed and evaluated by the Roybal Center for Enhancement of Late-Life Function at Boston University and the New England Research Institute, A Matter of Balance: Managing Concerns about Falls is an evidence-based program that promotes healthy attitudes toward staying active in the community as we age. Participants learn safe exercise routines, develop unique home modification plans, and gain confidence in talking with health care providers about falls / fear of falls.

ing flexibility, balance and strength • Anyone who is age 60 or older, ambulatory and able to problem-solve What can be expected during A Matter of Balance: Managing Concerns about Falls? • Group discussion • Problem solving • Role-play / skill building • Assertiveness training • Exercise training • Sharing practice solutions

A research study involving 434 subjects demonstrated the program: • Decreased fear of falling • Increased confidence in handling falls • Increased activity levels and mobility control • Enhanced social activity • Increased mobility range Who would benefit from A Matter of Balance: Managing Concerns about Falls? • Anyone who is concerned about falls • Anyone who has sustained a fall in the past • Anyone who restricts their activities because of concerns about falls • Anyone who is interested in improv-

Performance Physical Therapy is now offering the A Matter of Balance: Managing Concerns about Falls program. Bethany Carnevale, DPT a physical therapist and Matter of Balance coach hosts the 8 week course at various clinics. For information on upcoming classes please call 401-726-7100 or visit www.performanceptri.com/balance.html. Bethany can be reached bcarnevale@performanceptri.com.

• CONCUSS I O N S •

• CONCUSSIO NS • tainly more coaches, athletes, and parents who take concussion seriously now than there were five years ago, but the continued use of the old phrases like “he just got his bell rung” really do make an impression on young athletes and minimize the seriousness of concussion. Many states, including Rhode Island, have passed laws addressing concussion. According to the Rhode Island General law, coaches must now remove any player who exhibits signs or symptoms of a concussion from a game or practice. That player must obtain written medical authorization by a licensed physician before being allowed to return to play.

IT’S NOT JUST GETTING YOUR “BELL RUNG”

In the medical community, we are doing a better job of recognizing

Rehabilitation Stage

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(and the more recent media attention on concussion) that I started to think about what this phrase communicates.

indirect forces to the head. Concussive forces disrupt neural processes in the brain and affect the way the brain functions.

Despite all of the current focus on concussion, I find that many of my patients and their families don’t know exactly what it means to have a concussion. Contrary to the harmless image of a “ringing a bell,” a concussion is a disturbance in brain function caused by direct or

That’s right, a concussion is a disturbance in the way the brain functions! I spend hours each week trying to explain to frustrated athletes why it is important to rest and take time out of their sport. There are cer-

The consensus statement goes on to recommend a sample graded program of exertion otherwise known as a “return to play protocol,” as outlined in the table below. With the stepwise progression below, the athlete should proceed to the next

level only if he or she is asymptomatic at the current level. Generally, each step should take 24 hours. Therefore, as long as an athlete remains symptom-free, he or she would take approximately 1 week to proceed through the protocol. If any post-concussion symptoms occur during the protocol, the athlete should drop back to the level where there were no symptoms and discuss the protocol with their physician. The next time you hear the words “he had his bell rung,” think of the translation: “he suffered a traumatic brain injury which has caused a disturbance in the way his brain functions” – sounds a little different that way, doesn’t it?

Functional Exercise at that Stage of Rehabilitation

Objective of Each Stage

1. No Activity

Physical and cognitive rest

Recovery

2. Light Aerobic Exercise

Walking or cycling sub-maximal effort

Increase heart rate

3. Sport Specific Exercise

Running drills (field sports) or skating drills (ice hockey); no contact drills

Add movement

4. Non-contact Training Drills

Progression to more complex training drills (passing drills in football); may start progressive resistance training

Exercise and coordination

5. Full Contact Practice

Following medical clearance, participate in normal training activities

Restore confidence and assess functional skills

6. Return to play

Normal game play

By Jeff Manning MD

first heard the expression “getting your bell rung” when I started playing football in 3rd grade. It never struck me as particularly ominous. The phrase, uttered by my coaches in a lighthearted tone, was often used to minimize the effects of a big hit. As a high school football coach in Florida, I clearly remember players and coaches alike often saying “he just got his bell rung; he’ll be fine.” It wasn’t until I was in medical school

and appropriately treating people with concussion than we have in the past. Nevertheless, athletes are still making it back to practices and games without resolution of their symptoms or following a gradual return to activity protocol. According to the 2012 Zurich Consensus Statement on Concussion in Sport, “The cornerstone of concussion management is physical and cognitive rest until the acute symptoms resolve and then a graded program of exertion prior to medical clearance and return to play.”

Jeff Manning, MD, is a physician who specializes in sports medicine and is the Medical Director of Affinity Sports Medicine, an affiliate of Kent Hospital, located in East Greenwich, RI. He is also a faculty member with the departments of Family Medicine at Brown University and the University of Massachusetts. In addition, Dr. Manning sits on the Sports Medicine Advisory Committee of the Rhode Island Interscholastic League.

• CONCUSS I O N S •

• CONCUSSIO NS • toms associated with concussions including dizziness, headaches, and balance problems. If you are experiencing dizziness after a head trauma, a qualified physical therapist can evaluate you and determine what specific vestibular exercises are appropriate to reduce the symptoms of dizziness and improve your balance.

THINK STRAIGHT How Physical Therapy Helps Accelerate Concussion Recovery

Neck trauma is another common problem associated with concussions and can frequently contribute to a post concussion headache. Your physical therapist can do an accurate evaluation of your neck and develop a treatment plan that will aide in your recovery and minimize the discomfort associated with a headache.

Recover the right way after a concussion. Be sure that your healthcare professional team includes a physical therapist to help you get back to your team. For more information on the concussion program at Performance please visit: www.performanceptri.com/concussion.html

Brian Hay MSPT, DPT, OCS is a Clinic Director and the Director of Programs at Performance Physical Therapy. He is a mentor and instructor for Brown University Residents, and for Performance residents. Brian is certified in dry needling and specializes in sports injuries, orthopedics, running injuries, shoulder and spine and athletics. He can be reached at bhay@performanceptri.com.

By Brian Hay MSPT, DPT, OCS Photo: Megan Marcello MSPT, OCS prepares an athlete who suffered a concussion for a safe return to sport with sports specific drills.

he Center for Disease Control (CDC) estimates that 3.8 million sports related concussions occur each year. Early symptom recognition and concussion treatment is integral to preventing short and long term brain dysfunctions. As we continue to learn more about concussions and awareness continues to grow, physical therapy has become an important part of the healthcare professional team managing the recovery process. Following a concussion, one of the key components to recovery is limiting physical exertion. The more mental and physical exertion we place on our brain after a concussion, the slower the healing process. Recovery from a concussion is similar to recovering from any

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injury: if one puts too much stress on an injured area too early, we impede the healing process. Let me use the example of a sprained ankle, when the ligaments and tissue of the ankle get overstretched and torn. If you begin to walk on that ankle too early or try to run on that ankle too soon, it will have a compounded effect on the time it takes to heal. This same theory can be applied to a concussion. When a concussion occurs, there is a significant amount of trauma to tissue of the brain. Your brain is the control center for the body — it controls the way you think and the way you move. If you stress your brain too early, either cognitively or physically, you will significantly slow down the recovery process. Physical therapists help guide

an athlete through the recovery process by using specific benchmarks known as the “Return to Play Protocol” which research has shown to be effective. These benchmarks include the way someone’s heart rate responds to various levels of exertion and the way their vestibular system responds to different physical demands. These objective benchmarks must be met prior to proceeding to the next step in the rehabilitation process. Physical Therapy takes the “guess work” out of knowing exactly when and how much exertion is appropriate to promote proper recovery and tissue healing. Through the rehabilitation process, your physical therapist will also help address the common symp-

An Athletic Trainer’s Advice on Concussions Amanda is the head athletic trainer at East Providence High School, where she helps with preventing, assessing, and rehabilitating sports related injuries. Amanda has implemented a concussion screen to identify, educate, treat, and safely return athletes back to play. Additionally, Amanda works with the men’s rugby club at Brown University during their spring season. Amanda Moran ATC, LMT joined the Performance team in 2011. She graduated from Quinnipiac University in 2004, majoring in athletic training and went on to earn her Associates Degree in Massage Therapy from the Community College of RI.

What role do you play in assessing and screening for concussions as an athletic trainer at East Providence High School? Athletic trainers have an important job when it comes to assessing and screening for concussions, as we are often the first responders

to an athlete after they have sustained a hit. Knowing the student athlete’s personality, demeanor, and mannerisms before a concussion occurs can help alert us to an issue after they have taken a hit, if they begin to act out of their normal patterns. If a concussion is suspected, the athlete is removed from the field of play and put through a series of tests. These include asking the athlete about their symptoms and testing their memory, recall and balance, as well as a a cranial nerve assessment. If necessary, the concussed athlete is monitored and referred to a physician specializing in concussions. continued...

• CONCUSS I O N S •

We typically think concussions are associated with playing football. Are there other sports where you have seen student athletes getting concussions? Concussions are not limited to high contact sports. Concussion can occur in any sport with or without contact with another player. A baseball player can sustain a concussion at bat by being struck in the head with a wild pitch from the pitcher. A cross-country runner can sustain a concussion by tripping and falling, which causes a whiplash motion resulting in concussion symptoms. Athletes are not the only people to sustain concussions—anyone can sustain a concussion after a slip and fall or a motor vehicle accident. What are some of the strategies you recommend to prevent concussions? Prevention begins with education. The Consensus Statement on Concussions in Sports from 2012 states, “there is no good clinical evidence that currently available protective equipment will prevent concussions.” Helmets were designed to protect the head from skull fractures, not concussions. The skull is the brain’s own helmet, and because the brain is suspended within the skull, there is no way for the helmet to stop the movement of the brain. Educating an athlete on proper tackling mechanics and the implementation of rule changes to sports will help to reduce the number of concussions that occur each year. Tell us about the pre-screening or pre-season assessments that are used as a baseline. Baseline testing is done at the beginning of the season to obtain the athlete’s nor48 |

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mal status or baseline on the concussion test. We can then compare the results to those obtained after a concussion occurs and this helps to determine when it is safe to return an athlete back to the field. At East Providence High School, we baseline test the student athletes using software called “Impact.” The Impact test is a neurocognitive test performed on the computer that measures verbal and visual memory, processing speed and reaction time, as well as the athlete’s symptom scores. Do you think people are gaining a better understanding of the seriousness of a concussion? I do think that the general population is gaining a better understanding of the signs and symptoms associated with concussions. Organizations such as the NFL have also helped to promote the topic and their Heads Up Tackling program has helped to educate coaches, parents, and athletes about how tackling form can help reduce the number of concussions. I see a need for further education on the topic beyond just the signs and symptoms of the concussion. For example, how can a concussion impact an athlete in the classroom? What are the long term risks of sustaining multiple concussions? And, what are the benefits of undergoing an exertional testing program before returning an athlete back to full participation? How do you help a young athlete understand the seriousness of a concussion? Part of my education process on concussions includes a parent/athlete meeting at the start of the season. We explain our school’s protocols and show videos

of real life athletes who have sustained a concussion. This gives the athletes the perspective that concussions are a serious topic and can impact them or one of their teammates during the season. What do you recommend for anyone who has sustained a concussion? Alert the athletic trainer or coach as soon as possible! Once it has been determined that the athlete has a concussion, he or she should try to get as much rest as possible. Rest from both physical and cognitive work is important in the beginning stages of recovery, much in the same way we rest, ice, and elevate our ankle if we sustained an ankle sprain. Athletes should also be as truthful as possible about reporting any and all of their symptoms. Athletes sometimes omit symptoms because they don’t think they have anything to do with the concussion, when in fact they can be linked to the concussion. All athletes should undergo an exertional program before returning back to full participation in sports. Athletes can sometimes experience symptoms when they return back to sport because of the increase in their heart rate. The exertion program gradually increases the athlete’s heart rate under the supervision of a clinician in a safe manner before they return back to the field. Performance Physical Therapy offers a concussion program, including an exertional program. The beginning stages address balance and visual impairments, and gradually progresses to functional and sports specific drills.

USA Today Names Sandy Gorham Coach of the Year!

ongratulations to John “Sandy” Gorham, head football coach at East Providence High School, for being named Coach of the Year by USA Today. Coach Gorham has been coaching football for 21 years and has won more state titles (5) than any other coach for East Providence, as well as making it to the Super Bowl 7 times. Coach Gorham has received numerous awards including, four-time Rhode Island Football Coach of the Year, two-time RI Male Coach of the Year, RI Football Coaches Hall of Fame and the Providence Gridiron Hall of Fame.

ATHLETIC TRAINING

Jump & Land Drill Starting with the feet close together and knees slightly bent, crouch and jump over the barrier. When landing the chest should be over the knees, knee in line with the ankles. To add to the challenge, add an additional jump after jumping over the barrier followed by placing 5 to 8 cones/barriers in succession for continuous jumping and hopping.

AT PERFORMANCE PHYSICAL THERAPY

erformance Physical Therapy’s athletic training services aim to provide the best care for student-athletes who participate in extra-curricular activities. This is done through physical conditioning, injury prevention, immediate on-field care, clinical evaluation and diagnosis, the facilitation of medical referrals, treatment and rehabilitation . An athletic trainer is responsible for initiating and executing techniques to take control of life-threatening and emergency conditions through standard emergency care procedures. They are also responsible for administering therapeutic exercise and therapeutic modalities to facilitate recovery, function and performance. With proper preventative measures, most injuries can be avoided and an athlete’s performance can reach new heights. Such examples of prevention include: educating individuals about risks associated with participation to minimize risk of injury, inspecting standard protective equipment and environmental conditions daily, applying appropriate protective measures using commercial products and/or custom-made devices, implementing appropriate programs for physical conditioning, and promoting sound physical and nutritional practices.

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Whenever You Jump, Land, Stop, and Move..

Jennifer Gallant, MS, ATC, LAT stretches a Lincoln athlete on the sideline

Performance Physical Therapy is proud of its partnerships with Lincoln School and East Providence High School in working to build confident, strong and successful athletes. Lincoln School is an independent college preparatory school for girls in kindergarten through Grade 12, with pre-school programs for girls and boys in nursery and pre-kindergarten. www.lincolnschool.org East Providence High School: where townie pride means striving for academic excellence. www.eastprovidencehighschool.com

• Keep your toes straight forward • Land with your hips and knees bent • Do not let your knees collapse inward or go too far forward beyond your toes

• Keep your chest high and straight • Land softly on the balls of your feet and roll back onto heels • Distribute your weight as evenly as possible

For more information on athletic training services and resources for athletes please visit: www.performanceptri.com/athletictraining.html Jennifer Gallant, MS, ATC, LAT graduated from Bridgewater State College in 2007 with her Bachelor of Science Degree in physical education and athletic training followed by a Master of Science in applied kinesiology in 2009. Jen is a board certified athletic trainer and she provides athletic training services at Lincoln School in Providence RI since 2009. She is responsible for the implementation of ImPACT testing for all contact-sport athletes at Lincoln School. This past year she taught a professional in-service for taping techniques and continues to develop exercise programs to help improve performance and health. Her expertise is in the area of injury prevention and treatment for college & high school age athletes. Jennifer can be reached at jgallant@performanceptri.com.

Amanda Moran, ATC, LMT graduated with her Bachelor of Science in athletic training from Quinnipiac in 2004. Amanda provides athletic training services at East Providence High School as well as for the Brown University Men’s Rugby team. She is currently developing a concussion-screening tool to be utilized for the high school athletes. Additionally Amanda is a licensed massage therapist; therefore she is able to provide added benefits for the athletes. In June, Amanda biked 150 miles in an effort to help find a cure for multiple sclerosis. This is Amanda’s fourth year riding and she rides in honor of her aunt. Amanda can be contacted at amoran@performanceptri.com.

OUR GUARANTEE... • Increased Speed • Improved Balance • Improved Flexibility • Increased Endurance • Heightened Coordination • Enhanced Agility • Injury Prevention • Boost Self-Esteem • Team Building

The Performance Speed School’s mission is to emphasize the fundamental components required to be a successful athlete, while teaching the importance of teamwork, respect, communication, and commitment.

Performance Speed School is geared towards all sports including…

A STRONGER, FASTER YOU

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Baseball Softball Football Wrestling Volleyball Lacrosse

TEAM CAMPS

FUNCTIONAL MOVEMENT SCREENS (FMS)

Performance Speed School is also available for team consults. We will design a sports specific training program to give your team an edge on the competition. This is a one-time session at your practice facility that will focus on implementing a speed & strength conditioning program to address the specific needs of your team. Your team will also be provided with the tools to continue the program throughout the season.

We can assess teams or individual athletes to quickly identify imbalances in mobility and stability during fundamental athletic movement patterns. Using the findings from the Functional Movement Screen we can tailor your speed school experience to your individual needs to improve performance and reduce injury risk.

Care at Its Best

Basketball Tennis Soccer Track & Field Field Hockey Ice Hockey

TRAINING CAMPS For information on upcoming Speed School Training Camps please visit:

www.performanceptri.com/ athletes.html OR check us out on Facebook

PERFORMANCE SPEED SCHOOL IS… A training camp designed to maximize a young athlete’s speed, strength, agility, and flexibility, leading to better performance on the athletic field. Developed and instructed by experienced health care professionals who specialize in the areas of strengthening, injury prevention, rehabilitation and on-the-field athletic performance A unified team of athletic trainers, physical therapists, certified strength and conditioning specialists, personal trainers and kinesiologists.

WHO CAN BENEFIT... Male & Female Athletes Ages 9-18 College Sport Candidates Weekend Warriors

Testimonials... “What I was most impressed with was the fact that the kids worked so hard and enjoyed it at the same time.” − Neil Nachbar (13 yrs. Experience Tolman High School Volleyball Coach) “After having the Performance Speed School Staff work with our basketball team, we revised our conditioning program. Within just a few weeks our team seemed faster and stronger on the court. I would recommend the Speed School to any coach!” − Matthew Pita (Shea High School Men’s Basketball Head Coach) “What I love about this program is how the kids take to the exercises. They love it. They have fun and at the same time they are improving their speed, agility and balance.” − Ken Ryan (Former Red Sox Pitcher, Owner/Director of KR Baseball)

Co-Director of Speed School Certified Strength & Conditioning Specialist Physical Therapist Assistant ksilvia@performanceptri.com (401)726-7100

Dr. Brian Hay DPT, OCS

Co-Director of Speed School Board Certified Orthopedic Specialist Physical Therapist bhay@performanceptri.com (401)726-7100

Congratulations to the EPHS student whom was the recipient of the 2013 Performance Physical Therapy Scholarship John Vaughn III played football, basketball, volleyball and participated in outdoor track and field at EPHS. John was named 2nd team All Division for basketball. John now attends the University of Rhode Island for physical therapy. John pictured here with athletic trainer, Amanda Moran ATC, LMT.

• ATHLETE PROFI LE •

Jamie Pine A Tribute to Ronnie McFarland

eronica “Ronnie” McFarland has been the Athletic Director at Lincoln School in Providence for 13 years and in June 2014 will retire. She has dedicated her career to supporting and promoting girls’ sports in a variety of roles. Ronnie has had a tremendous impact on girls’ athletics, being instrumental in developing and strengthening the athletic programs at Lincoln School. After graduating and finishing her collegiate field hockey career, Ronnie began teaching Physical Education and Health at Somerset Public Schools. McFarland states, “I had the pleasure of coaching my first high school team to seven straight state championship appearances and quickly realized that leading girls to excel in athletic endeavors was my passion.” In 1995 Ronnie started teaching and coaching at Lincoln School. “As a product of an all girls’ education (K-12) I became aware at a very early age of the many benefits to a single sex education. I attribute many of my qualities and abilities today to having had the opportunity to learn in that environment. My best self was nurtured and inspired in those surroundings. Joan Countryman, the former head, offered me the opportunity to work at Lincoln School. Lincoln had a strong tradition of excellence in athletics and I was thrilled to become part of the program. I began my career at Lincoln as a physical education teacher and coach for field hockey and lacrosse. In 2000 I was appointed the Director of Athletics and with the support of the Board was given the resources to grow the program and improve the facilities. Since 2000 the Lincoln teams have gone on to win 21 Championships and many of our athletes have gone on to play their chosen sports in collegiate programs, at international levels and several continue to be involved today as coaches both on the high school and college level.” Ronnie had the vision and plan to improve the fitness center and the athletic fields at Faxon Farm in Rehoboth. The Faxon Farm project is now complete with a synthetic turf field,

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Awards: Providence Journal First Team All-State (2011, 2012, 2013), Rhode Island Interscholastic League Division 1 First Team All-Division (2011, 2012, 2013), Rhode Island Doubles State Champion (2011)

a new natural grass field, 6 stunning tennis courts and a fully equipped athletic training room. The facility is beautiful, stateof-the art facility strictly for girls!

What sports do you play and recreational activities do you enjoy? I started tennis when I was three years old, and have been playing competitively most of my life. I also play squash, and enjoy spending time with my friends and listening to country music!

Ronnie speaks about her mentor; “I was truly inspired by my high school coach Marie Snyder. Marie was a woman who believed that you could accomplish anything if you worked hard, challenged yourself to try new things and refused to give up on your dreams. She believed that women should be physically active and taught us all the benefits and importance of regular exercise. Marie was one of the pioneers in women’s athletics. She, along with a few colleagues, formed one of the first interscholastic leagues for girls and later became the first female Athletic Director at a local college. She inspired not only me but also at least a dozen others to pursue a career in athletics.”

Why did you choose these sports? When I was three, I began going with my parents to watch my older brother and sister’s tennis lessons. After seeing them play, I insisted that my parents sign me up too. Needless to say, they were slightly reluctant given that I could not see over the net, and was the same size as my racket. However, they signed me up and I have been playing ever since. I began playing squash this past year, to give a different racket sport a try. There was a little bit of a learning curve at first, but playing squash for my school was a really fun experience, and I will definitely continue playing.

“In my last year as the Director of Athletics at Lincoln School, I leave the program with a strong foundation to be able to further advance the athletic participation for the girls at Lincoln,” states McFarland. “I have always coached my players to seize the moment. I have now decided that the moment has come for me to seize the opportunity to take full advantage of our greatest gifts: good health and time. I look forward to pursuing new interests, perfecting some of my hobbies and most importantly-- getting to all of the things that I have planned to do over the past 18 years.”

Photo: Ronnie McFarland pictured with athletic trainer Jennifer Gallant MS, ATC, LAT, from Performance Physical Therapy.

Have you worked with an athletic trainer or physical therapist? I work with our school trainer, Jen Gallant, who has played a very big role in my athletic career. Aside from being the best at braiding hair, Jen has helped me through various injuries, and is the most supportive and helpful trainer I could ask for. Not only can she tape my ankles at lightning speed, but she is also the best person to talk to after a long day at school. During my first tennis match of the season this fall, I sprained my ankle. I still had the whole season ahead of me, and I knew that I had to keep playing. Jen taped my ankle for every match and practice, and she began to do some rehabilitation with me. By the end of the season, I had sustained two additional minor sprains, and something as simple as walking up the stairs became extremely painful. I saw an orthopedic doctor, who told me I had ligament damage, and following that I began going to Performance Physical Therapy. During my time at Performance, I continued to work with Jen as well as Paul Burke. They always kept me positive and motivated while I was injured. Jen and Paul both know

Jamie Pine is a seventeen year old 11th grader at Lincoln School in Providence. Jamie tells us about her athletic career, dealing with injury, goals and an inspirational coach.

how easy it is to get discouraged while injured, so they both went out of their way to help me recover as quickly as possible. How did you manage the frustration of not being able to play tennis? I was out of tennis for a little over two months, which was not easy for me because I have trouble going a week without playing. However, my physical therapist and my parents continued to assure me that I would return to tennis a stronger player, which helped me manage my frustration. My advice for other injured people would be to stay patient, because it takes time to completely recover from an injury. As frustrating as it is to have to sit out of your sport for a period of time, it definitely beats having a permanent injury. Is it difficult to manage the balance of time, between athletics, academics, and social time? It is definitely difficult to manage my time, especially since it is my junior year, and the college process is beginning. I think the most important thing is finding balance, and realizing that sometimes sacrifices will have to be made. Sometimes I have to sacrifice social time to travel for a tournament, but I might also have to sacrifice playing a weekend of tennis if I have a school obligation. My suggestion for others would be to find what activities are most important to you, and plan a balanced schedule around your priorities. What aspects of sports and athletics do you enjoy? I have always been extremely competitive, and I think that is why sports have become such a big part of my life. I love to compete, and I love pushing myself to get better. Sports, and tennis in particular, are the perfect combination between physical and mental training, and many of the skills I have developed through athletics, are useful in my everyday life. Do you have advice for people who say they ‘don’t like to exercise or play a sport’? My advice would be to give exercising a try, even if it is just for a short time each week. If working out in a gym doesn’t seem enjoyable, I would recommend playing a competitive sport. As a high school athlete I have found that playing a sport has given me more energy to do homework, and it decreases my stress levels.

What are your athletic and academic goals for the year ahead? With college applications and visits right around the corner, I want to continue to remain focused on my academics, improve my tennis ranking and abilities, and have a strong finish to my high school tennis career. Is there a coach or mentor who has been particularly inspirational to you? A mentor who has played an enormous role in my athletic career is Lincoln School’s athletic director, Ronnie McFarland. Mrs. McFarland is the type of person who never gets caught up in the moment, and always has her eye on the prize. She understands my drive to win better than anyone, and her ability to size up a situation always keeps me level headed. She can help me overcome even the toughest obstacles because of her incredible ability to deeply understand my strengths and weaknesses. Mrs. McFarland is also always there with her amazing pep talks; she knows exactly what to say, and when to say it. Her mentoring has guided me through the past three years of my high school tennis career. She has helped me become a better version of myself, both on and off the tennis court, and I am so grateful to have her in my life. If you could possess one super-human power, what would it be? Time traveling! I love history, and I have always wanted to see what it would be like to live in a different time period.

• AT H LETE PR O FI L E •

Nicole White Awards: Freshman year field hockey (2011): division 1 all-rookie team Sophomore year field hockey (2012): 2nd team all-division (D1) Junior year field hockey (2013): division 1 all-tournament team, 2nd team all-division, 2nd team all-state Has your team ever helped you during a challenging time in your life? My team helps me when I’m freaking out for a hard test or I’m just stressed in general. I feel safe and comfortable with my team and I know I can tell them anything. Have you ever been injured? Last lacrosse season I had a bad case of tendonitis. I was put in a cast for a mouth and was out for the second half of the lacrosse season last year. During field hockey season I noticed my shoulder subluxing and this fall I sprained my ankle. Jen Gallant, the athletic trainer, has helped me strengthen my ankles and legs. She has helped me so much throughout my time at Lincoln. She is also a person I can just vent to when I’m having a bad day. Before lacrosse season I started physical therapy with Paul Burke to strengthen not just my shoulder, but my whole body. Both Jen and Paul have been so important in keeping me on the field through multiple injuries. How did you manage the frustration of being injured? During lacrosse season I was really upset when I couldn’t play. I had a lot of energy bottled up inside me and many times Jen had to braid my hair just to keep me sitting down! I went to practice every day and supported the team. I would tell other injured people just to remind yourself that just because you aren’t contributing on the field doesn’t mean that you 56 |

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Nicole White is a seventeen year old 11th grader at Lincoln School from Cranston. Nicole plays field hockey and lacrosse and tells us about her athletic career, how she managed injuries, and her mother/ mentor.

aren’t a part of the team. Go to practice and every game to show your support to your teammates and find other ways you can help out. What aspects of sports and athletics do you enjoy? I love being on a team, being a part of something bigger than myself. I also love the structure athletics give me in my life. They actually allow me to do my best school work because it provides me with a place to release my energy and requires me to manage my time wisely. Do you have advice for people who say they ‘don’t like to exercise or play sports’? Sometimes exercising in the winter is tough for me, when I could just sit at home and watch Ellen, but really no matter how awful it is to get up and go to the gym, or go on a run you always feel a million times better after exercising. Playing a sport isn’t all about getting the goal or winning, it’s about building relationships with teammates and you don’t have to love the sport to do that. What are your athletic and academic goals for the year ahead and the future? I would really love to play field hockey in college, while pursuing medicine, and bring my game to the next level. But first, I want to focus on defending our state championship in lacrosse this year and making it far into the playoffs again in field hockey next year. In 10 years I hope to be working in the medical field as a primary care doctor or surgeon. Are there any coaches or mentors that have been particularly inspirational to you? My mom is the head field hockey coach and assistant lacrosse coach at Lincoln School. She is my biggest mentor. She was a great field hockey player herself and al-

though I never saw her play I can only imagine that she was as great a player as she is a coach. I choose to play field hockey because my mom played field hockey at UNH and coached at Burriville when I was little, so field hockey has always been a part of my life. When we are on the field my mom treats me not as her daughter but as a player. I like how she’s extra hard on me and it motivates me to do my very best every time I step on the field, whether for a game or practice. She is an amazing coach because I think she knows every one of her players just as well as she knows me on the field. She can pull out a person’s greatest quality and let it shine on the field while also improving their flaws. She makes going to practice fun, but everyone on the field knows that as much as we have fun we also mean business while we’re out there. What is your favorite post-exercise snack or meal? I love pasta and my parents make the best Italian food, which really fills me up after a game. If you could possess one superhuman power, what would it be? AI would like to be able to be lightning fast because I’m not the fastest person on the field so that would be cool to change that.

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