PIVOT! The Key to Moving Forward in Health, Wellness, and Life

Written By: Dr. Katie Wadland, PT, DPT, Board-Certified Geriatric Clinical Specialist

Owner: Healthy Aging Physical Therapy

"PIVOT! PIVOT!"

Lately, my kids have been watching Friends from the beginning, and as a ’90s girl myself, it’s been a total nostalgia trip. The quotes, the scenes, the moments that were so ingrained in my younger years are suddenly playing in the background of my house again. And of course, one of my all-time favorites - and probably yours too - is the Pivot scene.

You know the one. Ross, Chandler, and Rachel are attempting to move a couch up a narrow staircase, and as they get wedged in the corner, Ross repeatedly shouts "PIVOT! PIVOT!" in sheer desperation. The couch, of course, is going nowhere.

And as hilarious as that scene is, it also got me thinking - sometimes in life, we feel just as stuck. Whether it’s our health, our habits, our work, or something deeply personal, we often find ourselves wedged in a corner, unsure how to move forward. But just like Ross (though hopefully with a little more success), the solution is often simple: We have to pivot.

Why Pivoting is Essential

We tend to believe that change is impossible or overwhelming. Maybe it’s because we see others seemingly doing so much better, or because we’ve tried before and failed. Maybe we tell ourselves the odds are stacked against us.

But here’s the thing: we don’t have to see the climb the whole staircase - we just have to take the first step.

A pivot isn’t about a massive overhaul. It’s not about solving everything at once. It’s about shifting direction just enough to create momentum. And once we start moving, it becomes easier to make the next best choice, climb that next step - make our way towards the top.

Getting Patients to Pivot

As physical and occupational therapists, the hardest thing we face isn’t learning the latest new technique or mastering clinical documentation. It’s getting our patients to make changes - getting them to pivot toward better health.

We all know how easy it is to get stuck. We get set in our habits, convinced that things are unchangeable, too difficult, or simply not worth the effort. Our patients often feel the same way. When we encourage them to move more, to push past their comfort zones, or to try a new approach to managing pain, we’re often met with resistance. And honestly? We get it. Change is hard. But change is also necessary.

The key is not expecting someone to change everything all at once - it’s helping them take just one step. They don’t need to see the whole staircase. They just need to find where they can pivot in a way that makes sense for their life and circumstances.

How the Therapy Profession Has Pivoted

The role of the physical and occupational therapist has changed dramatically over the years. When I, and many of my colleagues, went to school, therapy education was focused on fixing. The emphasis was on what we, the clinician, could do to the patient - through our hands, through mobilization, through guiding patients through movement patterns. Most of the continuing education available after graduation were in specific manual therapy techniques or skilled handling techniques - designed to help people recover movement after an injury or a stroke. We were trained to believe that if we just applied the right technique, the body would heal.

But then science evolved. And guess what? It turns out, long-term improvements in movement, strength, or in pain reduction don’t come from what we do to a patient. They come from what the patient does for themselves.

The research is clear: Passive interventions - where the clinician is doing all the work - do not lead to long-term improvements in pain or function. What does work? Movement. Nutrition. Stress Management. Sleep. The things we put into our bodies. The activities we do with them. The rest we need to make sure that they get. And most importantly - the habits we build and maintain.

So, as science has changed, so have we. The field of rehabilitation has had to pivot. And as individual therapists, we’ve had to pivot with it. Because it doesn’t help anyone to keep doing the same thing that doesn’t work (isn’t that the definition of insanity?).

We've had to shift from focusing on what we can do to a patient to what we can empower a patient to do for themselves.

And science supports this shift - research like the OPTIMAL Theory (Wulf & Lewthwaite, 2016) highlights that people improve more when they:

• Believe they can improve (Enhanced Expectancies). Patients need to experience small wins to build confidence in their ability to change.

• Have control over their choices (Autonomy Support). When patients feel like they have control over their own care (rather than being told what to do), they are more likely to follow through.

• Focus on meaningful goals (External Focus of Attention). Instead of instructing a patient to “activate their glutes,” we might tell them to “push the floor away” or “root down and rise up, like a tree.”

It turns out, progress isn’t just about prescribing the perfect exercise - it’s about creating the right conditions for motivation, autonomy, and confidence to grow.

This is why Healthy Aging Physical Therapy does things differently.

How We Help Patients Pivot Toward Better Health

At Healthy Aging Physical Therapy, we don’t set goals for our patients - we set them with our patients.

✔️ Every patient fills out a self-assessment survey to help them identify what truly matters in their daily life.
✔️ We don’t just hand out exercises; we help our patients work through barriers that might get in the way of making lasting change.
✔️ We recognize that every patient is a whole person - not just a broken arm or a leg, or a back in pain. Every patient has a personal history, experiences, and individual challenges that impact their health and their sense of self-efficacy - or lack of it.
✔️ We take the time to understand our patients - their goals, their fears, and what drives them - because we know that real progress only happens when it’s meaningful to the person doing the work.

And let’s be honest - it’s not all unicorns and rainbows. We work with older adults. Many of them have 80+ years of experience, opinion, and habits that are sitting right there with them. That’s a lot of lived experience to navigate! But that’s why we take the time to build trust, to have real conversations, and to help our patients figure out where they can pivot to make the next best choice for themselves.

Final Thoughts: The Power of Small Shifts

At the end of the day, therapy (just like life) isn’t about finding a magic fix - it’s about making small, meaningful shifts in the right direction.

The next time you feel stuck - whether in your health, your career, or your personal life - channel your inner Ross Geller. Take a deep breath, assess the situation, and find your next best move.

Just remember: you don’t have to move the whole couch at once. You just have to pivot.

Wheelchairs 101: Understanding Wheelchair Options, Coverage and the Acquisition Process

Written By: Dr. Katie Wadland, PT, DPT, Board-Certified Geriatric Clinical Specialist

Owner: Healthy Aging Physical Therapy

As a physical therapist, I have had the privilege of working with many individuals who rely on wheelchairs to maintain their independence and quality of life.  The reasons for needing a wheelchair are as diverse as wheelchair users themselves, and a well-matched chair can make a world of difference. From those with new spinal cord injuries who require an agile, lightweight manual chair to take the place of walking in the setting of traumatic paralysis, to the patient who has had a stroke and now needs a specialized ‘hemi-chair’ designed for propulsion with one side of the body, each journey is unique.

While many people initially see a wheelchair as a step back, I often see it as a step forward. A wheelchair can open doors to independence, freedom of mobility, and a reduced reliance on caregivers. Although I sometimes encounter hesitation or pushback when bringing up the idea of a wheelchair, I frequently find that once the process is complete, my patients experience newfound freedom and vastly improved quality of life.

In my current practice, I most often work with patients with neurodegenerative diseases, like multiple sclerosis (MS) or Parkinson’s Disease, who can still ambulate part of the time but may need a wheelchair with custom features, like the ability to tilt-in-space, elevate seat height or powered mobility, to manage fatigue, enable longer-distance mobility, support posture in the presence of kyphosis and scoliosis and maintain independence in their daily tasks. Most recently, I had the opportunity to help my own mother obtain a custom power wheelchair. After living with Parkinson’s disease (PD) for 20 years, her postural impairments began affecting her ability to breathe, function, and manage back pain. The chair provided her with much-needed relief and now allows her to access her facility’s dining room even during periods when walking is too difficult due to ‘off times’ and back pain.

(PS: You’ll see some pictures from my mom’s assessment and fitting throughout the blog - special thanks to Derek Logan, PT, ATP from REQ for your help with this process!)

No two reasons for needing a wheelchair are the same. This is why a thorough assessment by a knowledgeable therapist, in collaboration with a skilled vendor, is essential to finding the best solution for each individual’s needs. At Healthy Aging Physical Therapy, we frequently provide wheelchair assessment training in conjunction with a variety of local vendors and I’d like to take this opportunity to shed some light on what this typically entails.

Wheelchairs, Scooters and Powered Mobility Options

When it comes to mobility devices, there are many options to consider. The choice between a standard wheelchair, a custom manual or power chair, or a scooter depends on the user’s specific functional and medical needs. Each type of mobility aid comes with its own set of features, costs, and considerations.

Scooters

Scooters are three - or four-wheeled motorized devices for individuals who can sit upright and operate controls but require assistance for longer distances due to weakness or cardiopulmonary conditions. Scooters are an excellent choice for those with some mobility but who experience fatigue with walking. They are often not covered by insurance and usually require an out-of-pocket investment ranging from $800 to $3,000. Many scooters can break down or fold up for transportation and can be tried at local durable medical equipment vendors and pharmacies.

PS: The above image is from the movie Thelma. If you haven’t seen it yet, stop reading and go watch it:)

Transport Wheelchairs

Transport wheelchairs are often purchased online or at medical supply stores and are the lightest, most easily transportable wheelchairs available. They typically have small wheels and limited seat and lumbar support; this enables them to be light enough to transport easily in and out of the car, but are also not designed for long term use as they do not provide adequate postural support for the user. Transport wheelchairs are not typically covered by insurance (unless you meet the criteria for a standard chair, but cannot self-propel and have a 24/7 caregiver who can assist) and cost anywhere from $100-$300 typically. 

Standard Manual Wheelchairs

Standard manual wheelchairs are the most basic option covered by insurance, and are often used for short-term needs or rental purposes. These chairs are manually propelled and typically cost between $100 and $500. They are ideal for individuals who do not require specialized features and need a temporary mobility solution. Medicare and other insurance plans may cover standard wheelchairs if they are deemed medically necessary, and are often issued during hospital stays in a ‘rent to own’ manner in which the Medicare beneficiary pays a small amount a month for thirteen months and then ‘owns’ the wheelchair.

Custom Manual Wheelchairs

Custom manual wheelchairs are tailored to the user’s specific dimensions and functional requirements. These chairs may include lightweight frames, adjustable seating, and positioning supports to enhance comfort and postural alignment. They are commonly used by individuals with conditions such as spinal cord injuries or neurological disorders. Custom manual wheelchairs generally cost between $1,500 and $5,000, depending on the materials and features. Custom manual wheelchair acquisition requires a wheelchair assessment by a therapist and vendor team, a visit with a doctor who will provide documentation to certify medical necessity, and insurance coverage often requires detailed documentation to justify the need for customization.

Power Wheelchairs

Power wheelchairs are motorized devices designed for individuals who have limited upper body strength or severe postural issues. These chairs can include advanced features such as recline, tilt-in-space, and elevation to address complex needs. Power wheelchairs are best suited for individuals with conditions like MS, Parkinson’s disease, or other impairments that significantly limit strength and mobility. The cost of a power wheelchair can range from $2,000 to over $20,000, depending on the level of customization and technology. Medicare typically covers power wheelchairs, but only after a thorough assessment to establish medical necessity. These assessments need to be provided by a therapist and vendor team, and the individual will also need to visit with their doctor who will need to complete additional paperwork (‘Face to Face’ visit) to support the medical necessity of this device.

Fun Fact: The average custom power chair weighs between 200 and 300 pounds. And, no, you cannot lift it into the trunk of your car!

Beyond Mobility: Other Important Reasons to Consider a Wheelchair

While mobility is often the primary reason for a wheelchair, there are several other important considerations that influence the need for a specific type of chair.

Preventing Skin Breakdown and Pressure Ulcers

For individuals who spend long hours in their wheelchairs, proper seating and support are critical to prevent skin breakdown and pressure ulcers. Specialized cushions, adjustable seat angles, and recline and tilt-in-space features can help individuals redistribute pressure and protect vulnerable areas, ensuring comfort and long-term skin health.

Providing Postural Support

Postural support is essential for individuals with trunk weakness or structural deformities. A well-designed wheelchair can enhance alignment, improving not only comfort but also critical functions like breathing and digestion. For example, we might choose to increase the seat angle (aka ‘seat dump’) and use a contoured seat back to improve pelvic alignment and maintain a healthy posture throughout the day, reducing pain and fatigue.

Enhancing Functional Abilities

Wheelchairs with advanced features can improve functional abilities in daily life. Elevating seat mechanisms, for instance, allow users to reach higher surfaces such as kitchen counters and cabinets, enabling tasks like cooking and cleaning. Additionally, alternative drive options like head controls or adapted joysticks can enable mobility even in users with limited hand function.

Reducing Caregiver Reliance

By addressing mobility and functional needs comprehensively, a wheelchair can reduce reliance on caregivers. This increased independence not only improves the user’s quality of life but also eases the burden on family members and care teams and can improve family dynamics considerably. 

How do I get a Custom Wheelchair?

Acquiring the right wheelchair is a multi-step process that involves collaboration between the patient, therapist, and vendor. Here is what to expect:

1. Initial Wheelchair Assessment: Your therapist and vendor team will conduct a comprehensive assessment of the individual’s mobility, strength, posture, and functional needs. This evaluation helps determine the type of wheelchair that will best meet the user’s requirements. These can be done in a Wheelchair Clinic or at-home with a provider like Healthy Aging Physical Therapy. You will have the opportunity to trial a chair similar to the one you will likely end up with to see if it would be a good fit.

2. Therapist/Vendor Collaboration: The therapist works closely with the wheelchair vendor to determine the best type of wheelchair for you, and identifies any necessary modifications or adaptations to meet your needs. They then work together to fill out the necessary paperwork and complete a Letter of Medical Necessity.

3. Documentation Submission: The prescribing physician, therapist and vendor provide detailed paperwork, including the assessment findings and justification for medical necessity. This documentation is submitted to Medicare or other insurance providers for approval.

4. Approval and Order Placement: Once the paperwork is approved, the vendor places the order for the wheelchair. Once approved, the equipment is ordered and the wheelchair is prepared for you. For custom manual or power chairs, this step may involve further adjustments and fittings.

5. Delivery and Fitting: Once the wheelchair is ready, your vendor and therapist will meet with you again to deliver the chair and provide any additional modification that may be needed. Things like the arm rest height and head rest position will need to be set for you specificically to ensure the best fit. If there are any larger issues, your vendor may take pieces of the chair back to be adapted as needed. 

6. Wheelchair Training: Now the fun begins! Just like learning to drive a car, learning to drive your new wheelchair will take some practice. Your therapist will work with you to learn to drive it forward, backwards and to turn so you can safely and efficiently navigate your home and community. 

7. Timeline for Custom Chairs: The entire process, from evaluation to delivery, can take anywhere from 6 to 12 weeks if everything goes smoothly. This timeline depends on the complexity of the chair and the speed of approval from insurance providers and can take up to 6 months at times if there are delays along the way.

Will Medicare Pay for my Wheelchair?

Medicare provides coverage for wheelchairs under its Part B Durable Medical Equipment (DME) benefit, but specific criteria must be met. Most commercial plans also have a DME benefit that is typically based on, or similar to, Medicare standards. Coverage is available when a physician prescribes a wheelchair for use in the home due to a medical condition that limits mobility. Here’s an overview of how this coverage typically works:

• Eligibility Requirements: Once you meet with your therapist and vendor team to trial your wheelchair and determine your needs, a physician must then conduct a face-to-face assessment and document the medical necessity of the wheelchair. This documentation is then submitted to Medicare for review.

• Types of Wheelchairs Covered: Medicare covers basic manual chairs (rent to own), custom manual chairs, and power wheelchairs if the features are medically justified.

• Scooters: Medicare may cover scooters in limited circumstances, such as when mobility is restricted both inside and outside the home, but this coverage is less common.

• Costs: For approved devices, Medicare typically covers 80% of the cost, leaving the user responsible for the remaining 20%, either out-of-pocket or through supplemental insurance.

• Modification and Replacement: Generally speaking, Medicare expects your custom chair to last at least 5 years. Should your chair require modifications or repair within that five year time frame, you will need to work with your vendor to fix your current chair in most situations. If modifications are required due to a change in your medical status, they may be covered by medicare, but repairs due to wear and tear may be an out of pocket cost. After five years is up, you may be eligible for a new chair should you demonstrate medical necessity for a new chair at that time. 

Choosing the right wheelchair is a collaborative process that requires a deep understanding of the individual’s needs and goals. By working closely with a skilled therapist and an experienced vendor, users can find a solution that not only meets their medical requirements but also improves their quality of life. Whether it’s a lightweight manual chair for someone with a spinal cord injury or a custom power chair for postural support, the right match makes all the difference. 

At Healthy Aging Physical Therapy, we are proud to offer custom wheelchair assessments in the comfort of your home. This approach can be incredibly beneficial, not only for individuals who may find it difficult to access a clinic but also for tailoring recommendations to fit seamlessly into your living environment. By evaluating how a wheelchair will work within your home - from navigating doorways to accessing essential spaces - we can ensure the best possible outcome for your mobility and independence. If you or someone you know could benefit from an in-home wheelchair assessment, we encourage you to reach out to learn more about how we can help.

Join the Healthy Aging Physical Therapy Team

Okay, time for some real talk.

The healthcare world right now? Let’s call it what it is: a bit of a disaster. Therapists are overworked, underpaid, and often put in situations where they can’t do their best work. Add inflation and Medicare cuts to the mix, and it’s not just clinicians who are struggling - practice owners are feeling the squeeze too.

But what if there’s a better way? What if there’s a practice out there committed to addressing these issues head-on? That’s what we’ve built at Healthy Aging Physical Therapy.

Why Healthy Aging Physical Therapy is Different

1. Beating Burnout

We’ve worked hard to create an environment that supports our therapists. Our full-time caseload is only six patient visits a day. That’s it. This allows you to actually breathe during your day and deliver the high-quality care your patients deserve.

We’ve also streamlined documentation with thorough but efficient systems, using elaborate quick texts and templates. These tools save time without sacrificing quality. We’re equally focused on patient and therapist satisfaction because, honestly, you can’t have one without the other. Happy therapists = happy patients - and we take happiness seriously around here.

2. Support and Collaboration

At Healthy Aging PT, you’re not alone. Our team thrives on collaboration, celebrating victories together and supporting one another through challenges. Whether it’s mentorship, ongoing education, certification opportunities, or equipment - we’ve got your back. Our number one goal is to help you grow and thrive.

3. Financial Stability and Growth

We’re realistic about the financial challenges in healthcare, but we’re also forward-thinking. We’ve diversified our income streams with our Wellness 365 program, a cash-based service that not only provides incredible value to our patients but also offsets the decline in insurance reimbursements. This approach ensures sustainability for our practice and sets us apart as a leader in innovative care.

For our staff, we’ve reimagined compensation. Instead of the small, insignificant 1-2% annual raises typically offered in healthcare, we share the profits. Each team member receives a percentage of our profits based on hours worked. When we work hard and grow together, we all share in the rewards.

The Result? One Incredible Team

Our approach has created an amazing team culture. Our therapists love what they do, and it shows in both their satisfaction and our patient experience. (Just check out our 59 Five Star Google reviews!)

What Do We Need Now? YOU.

We’re growing, our waitlists are long, and we need exceptional therapists to help us meet the demand. Here’s who we’re looking for:

• Physical Therapists + Occupational Therapists for the Medford/Melrose/Stoneham/Wakefield area.

• Personal Trainers + Massage Therapists opportunities available across all our our service areas!

We need people with the right mix of experience, compassion for the patient experience, and passion for their work. If you’re someone who values ownership of your time, wants better work/life balance, craves true meaning in your work, and loves being part of a supportive team - we want to hear from you.

Our Hiring Process

We take hiring seriously because finding the right fit matters. Here’s how it works:

1. Phone Chat: We’ll schedule a time to chat, so you can be clear from the outset on what what working at Healthy Aging is like, and what the role requires.

2. Shadow Day: Come spend a day with us to see how we work and how you fit with our team.

3. Open Book Policy: I’ll tell you how much I love working here, but clearly, I’m a bit biased;) To make sure you have all the info you need to make the best decision, I’m always happy to connect you with current or even past employees so you can ask the questions you may not feel comfortable asking in the interview.

If you, or someone you know, fits the bill, please reach out. We’re excited to grow our team and provide opportunities for therapists to thrive while making a real impact in our communities and in our patients’ lives.

Ready to chat?

Send your resume and cover letter to Katie@HealthyAgingPT.com and I’ll be in touch soon!

Reflections on my Goldman Sachs 10,000 Small Businesses Program Journey

Written by: Dr. Katie Wadland, PT, DPT, Board-Certified Geriatric Clinical Specialist and Owner of Healthy Aging PT

This past fall, I had the incredible opportunity to participate in the Goldman Sachs 10,000 Small Businesses program (10KSB). If you're not familiar, 10KSB is a nationwide initiative funded by Goldman Sachs, taught by Babson College professors, and designed to help small business owners grow their businesses through education, mentorship, and access to resources. The program is application-based, tuition-free, and brings together business owners from diverse industries to learn about the financial management, growth opportunity assessment, and leadership involved with business growth and development. (Curious? You can learn more about the 10KSB Program here.) Over the course of the past several months, I dove deep into every corner of my own business, from financial forecasting to marketing and new product development, and emerged not just a better business owner, but a more confident leader. Here are the five biggest lessons I learned.

1. Being a Business Owner is Actually Really Cool - and More Important Than I Thought

When I started Healthy Aging Physical Therapy, it was all about me—not in a selfish way, but because it was literally just me. It was a way to keep working during the pandemic while balancing homeschooling my two young kids. I started with zip, zero, NO formal business education, no plan, and a lot of trial and error. Over time, I realized that I wasn’t just filling a need for myself - I was meeting a huge unmet need in our community and decided to grow.

But what I learned through 10KSB is that small business owners are a rare breed. Did you know that according to the U.S. Small Business Administration's Office of Advocacy, only about 20% of small businesses survive their first five years? Or that small businesses make up 99.9% of all businesses in the U.S. and employ nearly half of the nation’s workforce? Additionally, 81% of small businesses have no employees, while only 19% employ staff, and of those, about 15% have between 1-10 employees. Healthy Aging Physical Therapy currently has a staff of EIGHTEEN (and looking to hire more!) Those aren’t just statistics - they represent real people, real jobs, and real impact.

Today, Healthy Aging Physical Therapy isn’t just about me anymore. We’re an employer, employing therapists, personal trainers and office management staff who love what they do and have the flexibility for real work-life balance. Walking into 10KSB, I felt like a therapist who happened to own a business. Walking out, I see myself as an entrepreneur, and I’m proud to be contributing to my local economy.

2. It's REALLY Important to Understand Your Numbers

Numbers used to intimidate me. For the first few years, I was in reactive mode - looking at financial data after the fact and making educated guesses about what to do next. The 10KSB program has changed that completely.

Now, I not only understand our financial foundations, but I’ve developed a forecasting model that allows me to proactively adjust factors like our service mix and staffing. Instead of anxiously riding financial waves, I feel confident and in control. I have back up plans, and a rainy day fund. I can spot trends in real time, understand what’s driving them, and take action before problems snowball.

Even more importantly, I’ve learned how our practice fits into the larger healthcare ecosystem. From policy changes to Medicare reimbursement cuts (Medicare reimbursement rates are going down another 2.8% as of 1/1/2025!), I now have the tools to navigate these challenges strategically rather than reactively.

3. I Feel Stronger Than Ever in My Vision for Healthy Aging

The first five years of practice ownership were about experimenting - trying new things, seeing what worked, and learning from what didn’t. Now, I have a clear roadmap for growth.

I’ve learned that being a good therapist isn’t enough. While growth is great, it’s more important for me to find ways to ensure the way we practice stays consistent with my values. To do so, I need to teach these principles effectively to my staff, create systems that ensure consistency, and build structures that support scaling and growth. I’ve gained confidence not only in my mentorship skills but also in my ability to scale without compromising our mission and core values.

While my goal as a therapist has always been to help as many people as I can, this practice has given me the voice and venue to MULTIPLY this in a way I never expected. The 10KSB has given me both confidence and the tools to scale my practice without losing the attention to care, compassion and evidenced-based practice that are so critically important to patient success. 

4. I’ve Learned I’m Not Alone

Running a business can feel incredibly lonely, especially when you didn’t set out to be a business owner in the first place. The stress, anxiety, and excitement of entrepreneurship are hard to describe to anyone who hasn’t lived it. I recently came across a meme that said “Being a business owner is great - you get to choose which 80 hours a week you work!” I laughed out loud because truer words have never been spoken - or meme’d about!

But in my cohort of 44 other business owners (shout-out to Group 2-2-2!), I found my people. We came from vastly different industries - there were water filtration experts, ice cream creators, restaurant owners, marketing experts, and more - but despite our different paths to entrepreneurship, we all share the same struggles - and now we get to celebrate our wins, together.  

Beyond our cohort, I’m now part of a nationwide network of over 14,000 10KSB alumni. That’s an incredible community of support, collaboration, and wisdom that I can lean on for years to come.

5. I Can Do Anything I Set My Mind To

This program was intense. Adding 15+ hours a week of coursework to an already jam-packed schedule was exhausting. But I did it - and have officially earned my Certificate of Entrepreneurship.

Running a private practice in today’s healthcare landscape isn’t easy. The constant threat of Medicare cuts, rising supply costs, and workforce shortages has made me second guess my plan many times over. But I’ve learned that the garden you tend is the garden that grows - it’s a simple analogy, but it’s true.

More importantly, this lesson extends beyond business. It’s about balance - something I’ll be the first to admit I haven’t mastered yet. Behind the business owner who seems to have it all together, there’s also a mom trying to find time to connect with her kids who are too-quickly growing their way out of her house, a wife trying to carve out quality time with her husband, and a human being who needs time for her own health and well-being (which has been largely ignored since August…).

If I could sum up my biggest takeaway from 10KSB, it’s this: I am in control. I can control my time, my business, and my priorities. I do NOT need to live in the ‘reactive’ anymore. The year ahead, and all the years after that, are full of potential - not just for Healthy Aging Physical Therapy, but for me, my family, my health, and my own peace of mind.

Looking Ahead 

This program wasn’t easy, but it was transformative. I’m heading into 2025 with a solid business foundation, a clear plan for growth, and a renewed commitment to balance and well-being.

To my team, my family, and everyone who’s supported me, and been patient with me, along this journey: thank you. And to any small business owners reading this - keep this program in mind. It's a heavy lift, but it’s worthwhile. Here’s to a purposeful and pleasant year ahead - for me, my team, my practice and my family.

Breaking the Fall Cycle for Fall Prevention Week

Written by: Dr. Katie Wadland, PT, DPT, Board-Certified Geriatric Clinical Specialist and Owner: Healthy Aging PT

Falls are a significant health concern for older adults, often initiating a dangerous cycle that can lead to more frequent falls and serious injuries. This Fall Prevention Week, we’re focusing on how the Cycle of Falling works—and, more importantly, how it can be broken with the right interventions.

The First Fall and Fear of Falling

The cycle often begins with an initial fall, leading to significant fear and anxiety about falling again. This fear impacts confidence in movement and results in avoiding daily activities. Nearly 50% of older adults who have fallen report limiting their physical activity afterward, which increases their likelihood of future falls.

At Healthy Aging Physical Therapy, we go beyond traditional therapies by teaching fall preparedness skills, including how to land safely and recover from a fall. Evidence shows that learning these techniques, along with the ability to get on and off the floor, reduces the fear of falling, which in turn lowers the risk of future falls.

Reduced Physical Activity

When fear limits physical activity, muscles weaken, and balance worsens. This sets the stage for more falls, as musculoskeletal strength is essential for stability.

We provide tailored programs that encourage safe, gradual increases in movement, helping individuals regain strength and reduce their fall risk.

Musculoskeletal Decline and Gait Instability

Reduced activity leads to muscle loss, joint stiffness, and decreased mobility, which all contribute to gait instability. This unsteady walking pattern makes falls even more likely.

Our therapists focus on improving strength, flexibility, and gait stability through evidence-based interventions like the Otago Balance Program, a proven exercise regimen designed specifically for fall prevention in older adults. By incorporating Otago exercises, we help patients maintain steady movement, balance, and mobility, significantly reducing the risk of future falls.

We also offer Strong and STEADI balance classes, which focus on improving balance, coordination, and strength to help reduce fall risk. These group classes create a supportive environment for patients looking to improve their mobility and confidence. You can find more information about these programs at Healthy Aging PT Group Classes.

Increased Fall Risk and Repeated Falls

As the cycle progresses, the likelihood of repeated falls grows, leading to a dangerous pattern. Breaking this cycle requires a comprehensive approach.

At Healthy Aging, we offer personalized fall risk assessments and targeted interventions, focusing on balance, mobility, and confidence to stop repeated falls before they happen.

One key aspect of our intervention is the Home Safety Evaluation. Our therapists assess your living environment to identify potential fall hazards and provide practical modifications. These changes, such as securing rugs, improving lighting, or installing grab bars, are crucial in creating a safer home, reducing fall risk, and promoting independent living.

How Healthy Aging Physical Therapy Can Help

We offer a variety of specialized services to address the Cycle of Falling, including balance and fall prevention programs, gait retraining, and strengthening exercises. Our team is committed to promoting safety, independence, and confidence for each individual. Check out more about our Balance and Falls Program here.

If you or a loved one are at risk of falling, take the first step towards breaking the cycle. Call us at (617) 398-4508 or fill out our New Patient Registration Form to schedule a fall risk evaluation.