March 2026 PULSE by PTSMC

MA MA

Address

It’sonly 20 miles away...how different could it be? It’sonly20milesaway...howdifferentcoulditbe?

Hopefully,everyoneisawarethatPTSMChasventured overstatelines,forthefirsttimeinour26yearhistory, into Massachusetts! A few people asked me, “what took so long”? The answer is straightforward. As a partner model organization, PTSMC has always looked to our aspiring leaders to help guide where our growth wouldoccur.

It wasn’t until last year that the right situation aligned with Eric Horne, now Easthampton, MA, Partner. He had declared, “Easthampton is my hometown. I grew up there and want to be part of revitalizing the town I wanttohelpmakeitagreatplace”

Eric started his journey as a PT Aide in the Avon clinic He became a clinician there, took a short stint at anotherPTpracticeinMA,thencameback tousinthe Simsbury clinic All along dreaming of bringing the PT For Life culture to his home state Once the decision was made that Eric was heading to MA, many PTSMC people mobilized to make his dream come true. I touched base with a few of the people in the mix and can confidently say that twenty miles and a state boarder turned out to be a heavier lift than anticipated.

Melissa Boutagy, Clinical Compliance Officer, completed a “Compliance Officer Acknowledgement Application” from MA. To begin the process, she applied for a Massachusetts PT license. She also suppliedcopiesofherdrivingrecord,allherPTrelated school transcripts, her official NPTE score, attested to her married name, and had it all notarized That was justthewarmup!

Jenn Detlefsen, Director of Billing, shared, “Researching the various new insurance networks and the contracting that came with it was a yearlong processandit’snotoveryet!Learninghowtonavigate this new world was a big focus of the billing, verification, and authorization departments We wantedtogetitrightforEric”

Jim Hungerford, Associate VP of Finance, added ,“We needed to engage a Massachusetts based law firm to rewrite our partner documents. We also had to deal with a complex business registration process and revamp some of our policies to reflect a change in the state tax laws. The entire process was different than Connecticut.”

Sandra Boccialetti, Director of Human Resources, agrees with Jim on the state policy side. Karen Havlicek, Senior Human Resources Coordinator, was instrumental in reviewing and revising PTSMC’s Employee Handbook and all PTSMC HR policies to be sure we aligned with Massachusetts Labor laws and requirements

Ryan Balavender, Director of Facilities, chimed in, “Theseprojectsarenotnormallyastraightlineandcan take you on unexpected journeys We had one signed letter of intent that the landlord voided, the Zoning Committee canceled multiple meetings at the last minute, and getting a plumber to show up was a nightmare!”

It’s only twenty miles, however at times it felt like walkinguphillinablizzard!

Eric’sfinalthoughtswhenwetalkedwas,“Iwantedthis, and I am HAPPY that we learned though all of it. The goal is to keep progressing and that is exactly what we did”.

Intheend,whichisactuallyanewbeginning,thismove challenged a lot of people at PTSMC to step up and grow in unexpected ways. I am excited and proud that we have a new frontier to build lifelong relationships andimprovethequalityofpeople’slives!

Eric&Melanie PaquettePSC

2026Lunch&Learns 2026Lunch&Learns

TheHRteamiscoordinatingaseriesof30 40minuteLunch& Learns forallemployees.Sessionswillincludepresentations ledbytheHRTeamorexpertguestspeakers.2026topics include:

FinancialResilience&Longevity

Makingthemostofyourbenefits

LinkedIn:connectwithusandexpandyournetwork Outlook,Teams,andSharePointtips

UnderstandingSocialSecurity

Allemployeesarewelcome,andparticipationisonpaidtime. Supervisorsareaware,sosimplyconfirmwiththemthat you’dliketoattend.

KeepaneyeoutforemailsandPULSEnotificationswith sign uplinks.Besuretoblockyourschedulesearly. Questions?Reachoutto NicoleDorosh.

FinancialResilience&Longevity:4Sessions FinancialResilience&Longevity:4Sessions

Gainvaluablefinancialinsightsandtipsbasedongenerations,from ouradvisorsatConnecticutWealthManagement,toempoweryour personalandprofessionalfinancialdecisions.Eachofthe4sessions willbedesignedwithcontentspecifictoageneration.Attendance welcometoanyandallsessions.Datestobeannounced.

CLICKHEREtosharewhatyouareMOSTinterested inlearningmoreabout.

March 12,

contribution reflects 3% of eligible

between July 1, 2025- December 31, 2025

Eligible employees who were active in the 401(k) plan between July and December will receive this contribution.

If you have any questions reach out via email or phone to Mallory Izmirlian.

Welcome

Abigail Bernier Westbrook PTA

Stacy Rivers Bristol PTA

Stephanie Davino Danbury PT Aide

Sage Wilson

Easthampton, MA PT Aide

ptsmc employees

Jenna Karaty Middletown PT Aide

Jenna Kilpatrick Fairfield PT Aide

Niki Laxton Windsor PSC

Not Pictured New Employees

Jaimi Anderson, Branford PT Aide

Nicole Loftus, Bristol PT Aide

Zanneika Satchell, Waterbury PT Aide

Nicole Solano, Danbury PT Aide

Promotion! Promotion!

Stars are referred by current employees!

March Anniversaries

Camille Mogelnicki

Jen Ashman

Liz Rubbo PSC Asst.Director PT

Tracy Collopy

Marquise Barham

Alannah Hernandez

Morgan Gelfand

Shannon Thompson PTA PT Aide PT Aide PT PT Aide

Glastonbury Simsbury Guilford

Branford

Windsor

Waterbury

Wallingford

New Haven

Promotion! Promotion!

Co-editingThePulse

CongratulationstoMarilexHarwoodonherpromotiontoanewroleat

PTSMC:DEILead&SeniorInternalCommunicationsCoordinator.This rolecombinesMarilex’samazingskillstoPTSMC’sbenefit.Shewill continuetoleadtheorganization’sinitiativestofosteracompassionate, inclusiveandsafeenvironmentforbothpatientsandemployees.Asour DEILeader,MarilexworkscloselywithPTSMCleadershiptoguide employeerelationsandprovideeducation,trainingandcommunication acrosstheorganizationforDEIrelatedtopics.

Marilex’snewresponsibilitiesincludebeinginnovative,creativeand intentionalinourinternalcommunicationmedia;representingourPTSMC mission,cultureandvalues.Theseadditionalresponsibilitieshavebeen buildingoverthepastninemonths.Theyinclude:

ManagingourSecondDoorplatformforLeadsandNPSengagementwithourpatients,reportingand accessforouremployees

CreatingconsistentinternalbrandedmaterialsincludingourEmployeeHandbook,Residency Handbook,CorporateCompliancePlan

PresentinginnovativepublishingofPTSMCandPTSMCprogramLinkedInaccounts

Supportingtheattractionoftoptalentthroughengagingandrelevantcontentforprospectivehires

SandyWickmanMason,VPofOperations,commented“Marilex’stalentsareamazing.Thediversityofher roleclearlydemonstratesthis.SheconsistentlydemonstratesPTSMC‘smission,commitmenttoDEIand PTforLifecultureandseamlesslypresentsthatincreative,innovativeandoftenfunwaystoourpatients andemployees.”

Promotion! Promotion!

CongratulationstoMichelleLinicusonherpromotiontoPatientServices CoordinatorinNewLondon!AfterbeingintroducedtoPTSMCasa patient,shejoinedPTSMCasaPTAidein2019.

Michellehasbecomeafamiliarfaceandtrustedpresenceforboth patientsandstaff.Shesayshertransitiontothefrontdeskfeelslikea naturalnextstepgivenherknowledgeoftheNewLondonclinic operationsandherpassionforprovidingpatient-centeredservice.Shehas alwaysenjoyedtheconnectiontopatientsovertheyearsandherroleat thefrontdeskallowshertosupporttheirjourneyandbeapartoftheir careinanewway.She’sequallyenergizedabouttheopportunitytolearn adifferentsideoftheclinicanddevelopherskillswhileworkingwiththe teamsheknowssowell.

ScottOlmstead,NewLondonPartner,hasseenhergrowtremendouslysinceshestarted,“‘Shelly’isone ofthemostreliableemployeeswehaveeverhad.Sheislovedandrespectedbystaffandpatients.There willbeabigholetofillintheday-to-daycareofpatientswithhermovetothefrontdesk.”

WhenaskedwhatshevaluesmostaboutPTSMCandtheNewLondonteam,Michelle’sanswercame easily:thepeople “Mycoworkersmakeitsuchasupportive,fun,andpositiveplacetowork Scotthasbuilt myconfidencetremendouslysincethedayIstarted andevenwhenIwasapriorpatientbeforeworking here!”

TheNewLondonteamisexcitedtoseeMichellecontinuetogrowandforallshewillbringtohernewrole!

Promotion! Promotion!

CongratulationstoChrisColleywhohasbeenpromotedto:Business DevelopmentCoordinator.ChrisjoinedPTSMCin2024asPracticeLiaison. Hehasservedasavitalconnectionbetweenclinicsandproviders,ensuring relationshipsarecultivatedandreferralsareformed.Hefeelsfortunateto workalongside,HeatherFeinerandJanetTarasuk,whohavealways sharedtheirknowledgeandexperiencewithhim.

InhisnewpositionforChris,ismostexcitedaboutcontributingtoPTSMC onalargerscale.Withabackgroundinsoccerasbothaplayeranda coach,Chrishasalwaysbeendrawntoteamwork,problem solving,and supportingotherstoreachsharedgoals.Theseexperienceshaveshaped hisleadershipstyleandlaidthefoundationforhissuccesses.

HeisinthecurrentcohortoftheAdministrativeLeadership&ManagementDevelopmentProgram (ALMDP),whereheisgainingknowledgeandskillstofurtherassisthimwithmovingPTSMCforwardin meaningfulandnewways.

Inthisnewrole,Chriswillmaintainhisfullterritory,andtakeonthefollowing:

LeadershipofthePracticeLiaisonteam

ManagethedataandreportingofPracticeLiaisonreferralsandperformance

Bethededicatedpersonforsupportingresearchandimplementationofpotentialnewlinesof businessopportunities.Forexample,heiscurrentlyresearchingdiagnosticultrasoundinPT,and supportingthecreationofasummertrainingcamphostedbySteveDale,ATC.

MikeDurand,VPofBusinessDevelopment,shared,“Chrishasbeenaninvaluableassettoourteam,and wearethrilledtoseehimstepintothisnewrole.Hisdedicationandexpertisehaveconsistentlydriven positiveresults,andIamconfidentthattheseskillswillbeinstrumentalintacklingfuturebusiness developmentopportunitiesforPTSMC.”

CongratulationstoNancyChilson,AvonPatientServicesAdministrator, onherupcomingretirement!NancyjoinedtheAvonteamin2014when PTSMCacquiredThePerfectWorkout.Althoughthatbusinesslinehas sincedisbanded,NancyhasbeenacornerstoneoftheAvonclinicever since Nancyrecalls,“WhenIarrivedatPTSMCinJanuaryof2014,Itold Travis(previousAvonPartner)Iwouldhelpoutfor8weeks.Ithasbeen12 funyearssincethen,withalotofchanges.Ihavereallyenjoyedworking witheveryoneandwillmissseeingTomandtherestoftheAvonteam.”

TomKirsch,AvonPartner,whohasknownandworkedwithNancysince hewasaPTAideshared,“IhaveknownNancythroughthemany evolutionsoftheAvonclinic,andwherewearetodaycouldnothave happenedwithouther.Ican’tthankyouenough,Nancy.Youhavehelped theAvonoffice,multiplepartnersacrossthecompany,andmelearnandgrowmorethanyoucouldever understand.Wewillallmissyousomuchandexpectfrequentvisits!”

Whenaskedwhatshe’slookingforwardtonext,Nancyanswered,“BeforeIstartedworkingatPTSMC,I visitedmy5sisterslivingallovertheUSandIamlookingforwardtobeingabletodothatagain.”

SPOT LIGHT SPOT LIGHT Employee FEmilyillionEmily Fillion

SeniorMarketingCoordinator,andpreviouslyInterimDirectorofMarketing, EmilyFillon,joinedPTSMCin2018 Sheearnedherbachelor’sdegreein communicationsfromFordhamUniversityandcompletedhermaster’sin interactivemediaatQuinnipiacUniversityin2019

Emilyoriginallychosemarketingandcommunicationsbecauseofherlovefor writing,buttoday,herrolespansfarbeyondthepage.Fromkeepingthewebsite currentandoptimizedforSEOtowritingblogs,managingpillarpages,planning socialcontent,coordinatingvideoproduction,overseeingthemerchandiseportal, andsupportingadvertising,shetouchesnearlyeveryaspectofPTSMC’s marketingefforts She’salsoanactivememberofthePULSEcommitteeand begantheALMDPprograminJanuary

Outsideofwork,Emily’spassionforhealthandfitnesscontinuestogrow.She becameacertifiedpersonaltrainerin2020andisconstantlyexpandingher expertise.Thismonth,shecompletedacertificationinpre-andpostpartum exercise,isbeginningherPilatescertification,andhashersightssetonearning herCSCS Herlong-termgoalistotrainyoungfemaleathletes-amissionrooted inherownexperiencefindingconfidenceandempowermentthroughsports Today,herclassesandone-on-onesessionsfocusonhelpingpeople,especially women,feelstrong,andcapable

Emilyfeelsespeciallyfortunatethatherprofessionalandpersonalpassionsover p strongbelieverinphysical therapy,sheseesfirsthandhowmovementtransformslives.Herexperienceasatrainerstrengthenshowshemarkets PTSMC,andhermarketingroledeepensherappreciationfortheimpactofpersonaltraining.It’satruefull-circle connection.

Whenshe’snotworkingortrainingothers,Emilystaysactiveherself.Shelovesweightlifting,playsinmultiplesoc volleyballleagues,andiscurrentlylearningspeedtrainingtoimproveherown5Ktime.She’scountingdownthedaysto warmerweathersoshecantakeheractivitiesoutside.Shelikestoshareherfitnessjourneyandtipsonsocialmedia, aimingtobringpositivitytoaspacethatisoftenoverwhelming.Hermessage:thebestthingyoucandoismove. Whenshe’snotmoving,Emilyisusuallyreading.She’spartoffourbookclubsandread75booksin2025.Thisyear,she’s aimingfor30,000pages,focusingonconsistencyoverbookcount.Fantasyisherfavoritegenre.

Emily runs the Manchester Road Race every year with her friends. This will be their 7 year! They go all out on costumes! th

She also enjoys video games and sports, often alongside her boyfriend, Darren Her go-to Nintendo Switch games include Pokémon, Animal Crossing, and FIFA She’s become a Liverpool fan, but her true loves are watching the U S Women’s National Soccer Team and the Yankees She was thrilled to see the women ’ s team play last year and makes it a point to attend at least one Yankees game each season.

At home, Emily has two rescue cats, Fergie and Olive, who are “happily co-dependent” with their owner. When she’s not home with them or juggling her many activities, she loves visiting her sister in TX and traveling with friends. She’s especially excited for a trip to San Jose later this year.

MARCH MARCH WELLNESS WELLNESS

What is the champion of wellness? Trick question –s all about balance! But let’s be honest — the world ellness can feel like madness. Physical, mental, social, and financial wellness all contribute to your all well-being. But trying to improve all four at That’s overwhelming. So instead of doing should really work on this,” we’re turning this into

everything, focus on one thing at a time

That’s where the March Wellness Bracket comes in.

Rather than another article telling you, “You a tool, because you don’t need more reminders that wellness matters.You need a clear starting point, and something that helps you decide what deserves your attention right now.

This challenge gives you permission to focus. One priority. One month. One commitment

The Game Plan

Fill out your March Wellness bracket by choosing the habit in each matchup that would make the biggest our life right now- Not what sounds best. ou think you should choose. Not what someone else suggests What do you actually need in

ou fill out your bracket, you will be left with a - a specific action you will commit to

or yourself Invite your family Compare ets with friends Make it fun- it’sYOUR challenge OUR commitment that matters most.

ellness isn’t about doing everything perfectly It’s about choosing intentionally and giving it a TRY. So… ancing in your bracket this month?

Like this strategy? Run it back in April. Choose a new champion next month. It doesn’t have to be what anyone else says is most important — it just has to be what’s right for you right now.

Movement: Schedule 20 intentional minutes of movement, 4 days per week for one month.

Sleep: Protect a consistent bedtime 5 nights per week to allow for 7–8 hours of sleep.

Nutrition: Add one vegetable at lunch, protein at breakfast, and fruit as a snack daily for 30 days.

Preventative Care:

Schedule one health screening and follwed by one proactive health step this month

YOUR MARCH WELLNESS GOAL

Growth & Learning:

Practice one NEW skill (personal or professional) 3 times per week for 30 days

Digital Discipline: Create one daily no-phone zone and protect it for 30 days

Professional Support:

Schedule one intentional development conversation with a mentor, peer, or professional.

Stress Management:

Take a 5-minute daily breathing reset for 30 days

Support System: Connect intentionally with one person per week through real conversation.

Gathering: Host, initiate, or attend one meaningful gathering this month.

Community Involvement:

Participate in one act of service that builds connection and purpose

Presence: Practice one fully device-free conversation each day for 30 days

Spending Awareness:

Track every dollar you spend for 30 days without judgment.

Emergency Savings: Save or add $500 to your emergency fund this month.

Debt Reduction: Make one extra payment toward your highest-interest debt.

Long-Term Savings:

Increase one retirement or savings contribution by 1% this month

DANBURY... DANBURY... isofficiallyopenin theirnewspace!

JoshMcAdamsand teamopenthedoors topatientsintheir newandupdated spaceonFeb9.

Thenewaddressis: 100MillPlainRoad Danbury,CT06811

Phonenumber remainsthesame: 203-616-2312

Partners & Directors met for their annual February meeting at TPC in Cromwell. While no golfing was done, the team spent a solid 9 hours learning, discussing, sharing, deciding, and socializing.

FFab5 Fab5 ab5

IhadanexcellentexperienceworkingwithMatt (Baronowski)andRyan(Nguyen) They supportedmebothbeforeandaftermyhip replacementsurgery,whichmadeahugedifference inmyrecovery Theirknowledge,professionalism, andabilitytochallengemeappropriatelyduring therapygavemeconfidenceandhelpedmeheal strongereachstepoftheway.Theentirestaffis friendly,welcoming,andalwayshelpful Itruly appreciatethecareandencouragementIreceived andhighlyrecommendtheBristolpractice.

-Bristol

ThisisthesecondtimethatIhaveusedthisteam andthisfacility-thefirsttimeforahipissueandthis timeforashoulderissue Inbothcases,Inever thoughtthatthePTapproachwouldwork,butin bothcases,Craig(Katko)puttogetheratreatment planthathasreturnedmetofullfunction Itisa cleanfacilitywithgreatequipment,andthePTsand PTassistantsareallveryhelpfulandknowledgeable. Iwouldhighlyrecommend -Essex

Connor(Sharp)wasgreatandhelpedsomuch withmyshoulderpain.Heisveryniceand considerate!

-Manchester Thestaffisamazingandtheenvironmentisreally welcoming Ihaverecuperatedvariousinjurieshere overtheyears,andthetransitionfromChurchHill PhysicalTherapytoPTSMCfeltseamless.

-Newtown

Channing(Harwood)washelpful,helistenedto meandeducatedmeonprocess,whatandwhyI requirethetreatmentsIdo,.Ifoundhimtobenot onlyhelpfulbutalso,hewantedtoworkand accommodatethebestplanforme Ifhehadnot,I wouldnotbegoingbackasIhavehadtherapistsbe directanduneasytoworkwith.Hewasfabulous.

-Wallingford

National Athletic Training Month (NATM) is held every March in order to spread awareness about the important work of athletic trainers. Thank you to all PTSMC AT's serving communities across CT!

Steve Dale, Guilford High School (Guilford)

Shannon Davi, Industrial &Tactical AT (Employer Services)

Mikayla Franklin, Valley Regional High School (Essex)

Harry Georges, Industrial & Tactical AT (Employer Services)

Ashley James, East Lyme High School (New London)

Michelle LaForte, Waterford High School (New London)

Erik Lanese, Holy Cross High School (Waterbury)

Sara Sullivan, Old Saybrook High School (Westbrook)

Shelby Pocius, Director of Employer Services

Madison Whalen, Sheehan High School (Wallingford)

An additional shout out to all the PTSMC clinicians, PT Aides, and Admin staff who are licensed Athletic Trainers, that provide AT coverage throughout the year!

ALMDP session on February 18 with Melissa Boutagy speaking on Compliance through out PTSMC as seen through the filter of a leader and Ryan Balavender, Director of Facilities discussing the "day in the life" of facilities management and a fun activity about choosing a new PTSMC location. From top row, left to right: Stevie Fell, Christine Spirtt, Janet Tarasuk, Melissa, Donna Baribault, Sandy Wickman Mason, Ryan, Lori Lawson, Christine Raffone, and Tracy Laramore.

ALMDP participants met on February 11 for training on KPI’s & Benchmarks, with Mike Durand. From top row, left to right: Emily Fillion, Sandy Wickman Mason, Evelyn Villarreal Laclede, Mike, Marilex Harwood, Chris Colley and Shelby Pocius.

Steve Dale

Madison Whalen

Sara Sullivan

CLINICAL EXCELLENCE CLINICAL EXCELLENCE

Clinicians attended the Level 1 SmartCuffs Blood Flow Restriction (BFR) Training Course, hosted by PTSMC at the Hamden clinic.

Congrats to the following PT Aides who completed the Skills Introduction for PT Aides Program:

PTSMC partners, directors and clinicians represented at the APTA Combine Sections Meeting (CSM), in Anaheim CA. Pictured above, Ryan Solorzano, Danielle Dunn, Rebecca Petrosino, Erin Walsh, and Emily Steele.

Daniel Borean, Branford

Jenna Karaty, Middletown

Olivia Lamas, Wallingford

Kelly Trivella, Essex

Maia Ventresca, New Haven

Nylah Wells, Windsor Brynn Wisniewski, Bristol

Therese Zalenski, Monroe

Chris, Healther & Janet met with Katie Biggs, Athletic Trainer and Physician Extender for Yale New Haven Health Orthopedic Surgeon/Sports Medicine

Doctor, Dr. Christina Allen. Katie Redman (West Hartford Director) & Janet hosted an in person Lunch & Learn with Dr. Matthew Partan, Doctor of Osteopathic Medicine from UCONN Health Orthopedics. The event was attended by clinicians from Avon, East Hampton, Manchester, Simsbury, West Hartford & Windsor.

Student Program Update

Enriching The Experience Enriching The Experience

PTSMC has so much to offer our students. Below are a few pointers that CIs can use with students about future opportunities. These small efforts also help showcase what makes PTSMC so special:

Share the DOCS Program

The DOCS program sets PTSMC apart. If you ’ re a DOCS graduate or finishing up the program, share your experience with mentorship and internal courses. Invite your student to join a monthly Case Discussion to get the first-hand experience.

Highlight our Partnership Model

The PTSMC Partner Model is unique and often fascinating to PT students. Connect them with your clinic’s Partner to provide these insights to the potential leadership opportunities at PTSMC.

The virtual LMDP session on February 19, featured guest speakers Melissa Boutagy, Caty Mulligan & Sandra Boccialetti, on compliance, PT Aide hiring, training & SIPTA program, HR policies, feedback and employee discipline process. Pictured top left to bottom right:

Sandy Wickman Mason, Melissa, Leah Cummings, Ray Weitekamp, Jackie Fernandez, Ryan Nguyen, Jeff Panepento, Mike Popolizio, Liz Rubbo, Brianne Dwyer, Sandra and Caty.

“My affiliation with PTSMC was amazing, extremely awarding, and I genuinely left feeling like I have learned a lot about treating patients in the outpatient environment. I would absolutely do it again.”

-Student on final affiliation

Highlight the PTSMC Orthopedic Residency Program

Another program that sets PTSMC apart from other private practice PT in New England. Connect them to resources about the program on the PTSMC website or connect them to a graduate so they can hear more about the experience. Extend an invite to an upcoming program information session (reach out to Danielle Dunn).

Engage in Community Events

Let students see the impact we make beyond the clinic. Invite them to join a community event with you or your team.

Offer a Surgery Observation

Do you have a strong relationship with a physician group? Consider coordinating a surgery observation. This is a highly requested and memorable experience for many students, helping them connect clinical decision-making with surgical procedures and post-operative care.

Brian Vo welcomed baby boy Oliver Louis Vo born January 28

Watertown surprised Pete Catuccio for his birthday with custom t-shirts �� The look on his face when he saw them was priceless!

Nate Gockel welcomed baby girl

Amelia May born January 27

UHC Rewards- Unlock More Value from your Health Plan!

EmployeesenrolledinmedicalbenefitswithUHCthrough PTSMC,it’stimetotakeadvantageofthevaluableincentives offeredthroughtheUHCRewardsprogram;makeyourhealtha priorityandearndollarsforyourefforts!Thisprogramprovides upto$1,000peryearinrewards.Employeesandenrolled spousescanearnrewardsintheformofaVisae giftcardoran HSAcontributionbyreachingprogramgoalsandcompleting one time,daily,orweeklyactivities.

Belowisacharthighlightingtheopportunitiestoearnrewards dollars.Manyactivitiescanbecompletedusingafitnesstracker, makingiteasytoparticipateandstayengaged.

Rewardsdollarscanberedeemedatanytimeonceyoureacha minimumbalanceof$5.Rewardscanberedeemedthrough myuhc.comortheUnitedHealthcaremobileapp,whereyoucan maketheselectionofaVisae giftcardoranHSAcontribution. Getstarted,andbeginearningTODAY!

The ExtraMILE

The Awkward Stuff: Supporting Patients in Their Most Vulnerable Moments

Not every part of a patient visit feels easy or comfortable, and that’s okay Physical Therapy is personal Patients move in ways that feel unfamiliar They talk about pain, money, and limitations They place their trust in people they may have only just met Along the way, there are moments that feel awkward, even if no one says it

Sometimes, a patient feels embarrassed about their body or mobility.

Sometimes, they feel stressed when insurance or copays come up. Sometimes, they worry about pain, doing something wrong, or being judged for not progressing quickly enough. Sometimes, they simply feel rushed at a moment when they already feel vulnerable.

These moments don’t appear on schedules or treatment plans, yet they have a real impact on how supported a patient feels

What going the extra mile means:

Going the extra mile doesn’t mean solving every discomfort. It means noticing what is happening and taking a breath. Slowing your pace. Offering reassurance. Making space for questions. Reminding patients that progress doesn’t have to follow a straight line.

When we acknowledge discomfort before a patient has to name it, we create room for trust. And trust is central to wellness.

Patients may not remember the exact awkward moment, but they will remember whether they felt respected, supported, and safe.

As we think about customer service and wellness, it’s worth asking: Where might a patient feel uncomfortable today? What small action could help them feel more at ease?

Meaningful care often happens in quiet moments – when patients feel seen, heard, and supported.

Extracorporeal Shockwave Therapy for Musculoskeletal Conditions: A Snapshot of Clinical Overview and EvidenceBased Practice

Roslin DellaVecchia, PTA

Watertown Physical Therapist Assistant

Extracorporeal shockwave therapy (ESWT) is a noninvasive intervention that delivers acoustic pressure waves to stimulate biological repair in soft tissue and bone.2 In outpatient orthopedic physical therapy, ESWT is valued for managing chronic tendinopathies and related musculoskeletal pain syndromes unresponsive to conservative care.1,2 Evidence supports its use for plantar fasciitis, Achilles and patellar tendinopathies, lateral epicondylitis, and calcific rotator cuff disease, with outcomes often matching or surpassing injection therapies in long-term function and pain relief.1,2

What Shockwave Therapy Is (Clinically)

Clinically, ESWT delivers short-duration, high-pressure acoustic waves that produce controlled mechanical stress in target tissues. Two types of ESWT are used in the outpatient setting, either separately or in combination; focused ESWT (F-SWT), which concentrates shock waves deep to the point of contact, and radial ESWT (R-SWT), which exerts maximal pressure superficially at the site of contact with attenuation into underlying tissue.1,3 Optimal dosing combines the following variables to achieve mechanotransducive effect without excessive tissue disruption, providing a reproducible clinical framework for musculoskeletal application: energy flux density (EFD) measured in mJ/mm², frequency (Hz), and number of impulses (pulses per session) or the product of the pulse frequency (pulses per second) and the total treatment time (seconds) 1,4

Mechanotransduction Causes a Biological Cascade

ESWT initiates a mechanotransduction cascade, where mechanical impulses are converted into cellular activity that promotes repair 1,3

Figure 1: a. Focus Shockwave Device (EH-generated by means of spark gap); b. Pressure field of a radial shockwave device.3

Cellular & Molecular Effects

The transient microtrauma generated by shockwaves increases membrane permeability, ion exchange, and local metabolism 1,3,9 This controlled stress stimulates the release of growth factors and signaling molecules that promote angiogenesis and tissue regeneration.5,6 The mechanical energy further reduces nociceptor sensitivity through the gate theory of pain via hyperstimulation analgesia, explaining the immediate pain relief observed clinically.1,2

At the cellular level, ESWT enhances angiogenesis via upregulation of vascular endothelial growth factor (VEGF) and endothelial nitric oxide synthase (eNOS), promoting neovascularization 6,7 Collagen synthesis is driven by the transformation of growth factor-β1 (TGF-β1) and tenocyte proliferation, while osteogenesis involves bone morphogenetic proteins (BMPs) and local nitric oxide signaling that activate osteoblasts and suppress osteoclasts 4,8 Anti-inflammatory effects include downregulation of IL-6, TNF-α, and Substance P, reducing pain transmission and cytokine-mediated degeneration.1,4,9 These responses collectively reestablish tissue homeostasis, supporting the therapeutic role of ESWT for use across tendon, bone, and fascial structures.9

Effects on Musculoskeletal Tissues

In tendons, ESWT enhances collagen realignment, TGFβ1 expression, and tensile integrity, improving load tolerance.⁶ Fascial tissues respond with reduced stiffness and enhanced glide, optimizing movement efficiency. Bone benefits through osteogenic signaling, angiogenesis, and accelerated healing of delayed unions or stress fractures ⁴ , ⁸ At the neural interface, reduction of Substance P and calcitonin gene-related peptide (CGRP) modulates nociceptive transmission ⁹ Functionally, these adaptations translate to pain reduction, restored mobility, and improved biomechanical function in chronic musculoskeletal disorders

Evidence-Supported Clinical Uses

Evidence strongly supports ESWT in the management of plantar fasciitis, Achilles tendinopathy, lateral epicondylitis, patellar tendinopathy, and calcific rotator cuff tendinopathy.10-14 Both F-SWT and R-SWT demonstrate efficacy, with combined application offering depth-specific benefits. In plantar fasciitis, ESWT significantly improves pain and function compared with placebo and provides longer-lasting outcomes than corticosteroid injections 11 In chronic Achilles and patellar tendinopathies, ESWT enhances tendon remodeling and load capacity compared to placebo group 12,13 Overall, ESWT outperforms passive modalities and yields clinical outcomes equivalent or superior to injection-based treatments in long-term followup.1,4,10

Contraindications, Precautions & Clinical Pearls

Extracorporeal shockwave therapy (ESWT) is generally safe but contraindicated in active infection, malignancy, and pregnancy, with caution advised for coagulopathy, anticoagulant use, pacemakers, and recent corticosteroid injection 1,2,4 Minor adverse effects include transient pain or bruising; rare complications, such as tendon rupture, can occur with high-energy applications 1 Clinicians should avoid local anesthesia and NSAIDs post-treatment to enable pain-guided targeting, and integrate ESWT with rehabilitation to optimize outcomes 1,2 Ongoing clinician education in procedural safety, ergonomics, and dosing are essential to ensure efficacy and minimize patient risk 1

Cli k H f R f