“You Actually Care”: Why Soft Skills are the Key to Effective Therapy

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

The other day, a patient’s spouse looked at me, and said incredulously:

“It’s like you really understand her and actually care. You’re not just going through the motions.”

I instantly teared up, because I’m a giant crybaby, but it really got me thinking.

I do care. And the fact that he said it with such surprise broke my heart. Because while it felt so natural to me, to him, this wasn’t the norm — and that’s is a problem!

It also reminded me that what we are doing is different—and it’s working! This is exactly what I want every patient and family to feel when they work with us at Healthy Aging Physical Therapy. And it’s why I’ve built our practice, intentionally, to protect and promote what I think is the number one differentiator in great care: effective soft skills.

The Problem: A System That Strips Away the Human Side of Health Care

In today’s healthcare system, connection is rare. You go to your MD and they are typing more than they talk. The visit is often less than 15 minutes. There’s little to no time to ask questions. Patients rarely feel truly heard.

In many outpatient therapy clinics, time with your therapist is limited. You might spend 15-30 minutes with your clinician, but the rest of your session is with an aide or tech, often in an open gym, surrounded by other patients. While the shared gym environment is motivating for some, it can make it difficult for others to be open or vulnerable.

Home care should feel more personal, but even that has become transactional. With nursing shortages, therapists are being asked to address issues beyond their scope. Visits are often 30-40 minutes at the most, and a large portion is spent on answering multiple-choice questions for Medicare and making sure those are complete to ensure payment. 

Please know, none of this is said to slight any of these healthcare providers — clinicians are, by and large, well-meaning individuals working under extremely challenging conditions. Rather, these are symptoms of a systemic issue. Financial and administrative burdens, staffing challenges, and healthcare inequity are strangling our system. And while clinicians struggle to get through the day, the ones truly suffering are our patients.

The Solution: Shifting to Model That Puts the Care back in Healthcare

When I started seeing patients under the Healthy Aging model, something shifted for me. I had spent years in settings where I felt I had to  rush through the "subjective" portion of an eval, get through the history in 10 minutes or less so I could move on to the "real" work: strength testing, range of motion and outcome measures.

But once I gave myself permission to slow down and listen, my evaluations transformed. It started taking me 30, or, sometimes more, minutes to get through my subjective - not because I was inefficient, but because I let myself get curious. And the more curious I became, the more I learned. Learning more about my patients helped me design better plans for their care. And I found that as my relationships grew stronger, their outcomes got better.

I needed that time to get to know my patients beyond their past medical history and med lists. I wanted to know more than just their goals, but about their lives:

• Tell me about your home. Have you lived here a while? Did you raise your family here? Is it important to you to age in place? Have you looked into supported living settings or do you want more information?

• Who helps you day to day? Do you have family, friends, caregivers involved in your life — or need help finding more support? What needs feel unmet?

• Tell me about your grandkids and your pets, your church groups and what you do in the community. How do you spend your days?

• How are you feeling — not just physically, but emotionally? Are you in a place where you can focus on therapy, or are there other issues that need to be addressed first?

• How is your sleep? Appetite? Hydration? Do you have access to healthy food?

• How do you feel about exercise? Love it? Hate it? Have you had PT before? Was it helpful? What gets in your way of being more active?

These questions aren't luxuries. They are essential. They help me develop a plan that reflects who they are, where they are, and what matters most to each of them.

That single shift, from checking boxes to checking in, changed everything.

Structuring a Practice Centered on Soft Skills

It wasn’t enough for me to work this way. I wanted our whole practice to reflect this approach. That meant building a structure that not only allows for soft skills, but rewards them. How do we do this?  From hiring to training to the way we structure our sessions, compassionate, patient-centered care is the foundation and everything stems from there.

• We hire for heart, not for accolades. When I interview a prospective therapist or personal trainer, I’m not looking for specialty certifications, or awards on their resume. I’m looking for the people that care. Therapists and trainers that care about the work they do, the patients they work with and the colleagues they work beside. I’m always on the lookout for someone that has something special to give, who wants to learn more, and collaborate with their peers.  

• We book our visits for a full hour.  After years of rushing around in home care, I didn’t want to feel rushed anymore. Our patients deserve better. They need time at the beginning to talk and settle in, and time at the end to wrap up, reflect and make a plan for the next week. After treating this way for five years now, I can’t even imagine going back to a shorter visit. 

• Our clinicians are paid for time, not for productivity. If one of our therapists spends an hour and a half with a patient, they are paid for an hour and a half of their time - even if half of that was dealing with a non-billable need. It happens! This frees our therapists to be present and focused and without worrying about productivity quotas or time crunches.

• I train each of our therapists to evaluate with intention. When someone joins our practice they accompany me on an evaluation before going out on their own. I model what I teach, and have systems in place to help guide them in asking the important questions. I can’t tell you how many times I finish an evaluation and a patient or their family says to me ‘I’ve had a lot of PT, and no one has ever asked me these kinds of things.’ This is how I know I’m on the right track. And when a patient feels seen and understood, they are more willing to do the work.  

• We lead with our core values. They’re printed on the first page of our patient booklets, woven into our orientation, and reflected in how we speak, act, and show up for care.

  Healthy Aging Therapists are:

• Patient Centered + Holistic

• Empathetic + Compassionate

• Collaborative + Approachable

• Fitness-Forward + Functional

• Evidence-Based + Education-Focused

And our mission statement says it all:

Healthy Aging Physical Therapy delivers specialized outpatient-at-home physical therapy, occupational therapy, and wellness services to support optimal aging for older adults, individuals with Parkinson's Disease, and those with complex medical needs. Our unique in-home model reduces barriers to access, is driven by patient-centered goals, emphasizes education, and embraces a holistic, whole-health approach. We believe in movement as medicine, that every body has the ability to improve, and that above all else, kindness matters..

5 Soft Skill Tips for Therapists Who Want to Provide Better Care

If you’re a therapist reading this and thinking, "I want that, too!" here are my top 5 tips to improve your own soft skills and get better results:

1. Take the time to talk, even if it takes time away from something else.

Taking that extra time not only at evaluation, but at each session, to engage, ask, and listen will pay dividends in patient engagement, motivation, and success. So what if you didn’t get to complete that Berg today or see how they did on the stairs. You’re in it for the long game and not everything needs to be accomplished on day one - you can always get to it next session. That time spent talking isn't wasted - it's essential.

2. Don't write off the "hard" ones - they are the ones that need your care the most.

Frustrated by your ‘unmotivated/unwilling’ patient? Don't just write them off as lacking potential, being non-compliant or unwilling to participate. These are the ones to DOUBLE DOWN ON. Really dig in - get curious! Why are they struggling to participate or follow through? Are they anxious, overwhelmed, or confused? Are there cultural barriers or limiting beliefs?  What do they care about? How can you change your approach to meet their needs? Do you need to consider layering other support services to approach their case in a more multidisciplinary way? Are your goals reasonable or do they need to be more accommodative and realistic for this situation? Everyone has potential - sometimes you just need to look a little deeper, try a different approach or add in the additional support they need to thrive.

3. Be ready to modify your game plan.

Our patients are not robots - and rehabilitation is not linear. You need to be able to walk in the door, assuming things may not go as planned. The days your patient is painful, stressed or anxious are not the days you are going to get everything done. You need to be flexible and prepared to pivot. This is a skill learned through experience, and I do think it’s one of the hardest things for a student or new grad to understand right off the bat. My advice is to talk with your patient first before making the plan for the day, guide them towards the best choices during your session instead of telling them what you are going to do, and have goals, not plans, for each session.

4. Ask questions, at every visit.

And I’m not talking about ‘How is your pain on a 0-10 or did you do your Home Exercises?’ Read up on motivational interviewing and adapt your questions to your patient’s capability. Looking to get a sense of perceived rate of exertion? Wondering if your balance challenge was hard enough? Yes, there are a million validated pain scales and exertional scales out there, but honestly, who wants to be given a piece of paper with 20 numbers and colors and smiley faces every time they do a new exercise. It’s okay to keep it simple and just ask how it felt - “Was that easy, medium or hard?” “Could you handle another set or need a break?” “How could we make this harder? Want to try closing your eyes or a different surface?”  Let your patient make the choices (Bonus - it’s better for neuroplasticity!) - "Anything you want to focus on today?" “We’ve got 15 minutes left - would you rather get outside for a walk or try this new game I brought?” Ask questions that focus on the wins - “What went well this week?” “Tell me one thing you can/will/want to do this week to work towards your goals?” Questions keep your patient engaged and keep you focused on what they truly need.

5. Put the CARE back in your Care Plan.

We all got into this field for the right intentions, but too often, corporate healthcare, big hospitals and practices that prioritize profit over people slowly take this from us. We’re pushed to be more outcome driven, instead of more caring, more efficient instead of empathetic - and this inevitably leads to burnout. If you work somewhere and you feel like your ability to care (not just ‘provide care’)  is being stifled, change it. Advocate for a better model. Leave if you need to. Or build something new. Don’t settle for the status quo and remember why you chose this career and take the steps you need to find joy in it again.  Bring back the care back to healthcare. Make soft skills the standard, not the exception.

Dizzy? Don’t Wait. Why Early Treatment for Dizziness MATTERS.

Written by: Dr. Katie Wadland, PT, DPT, Board-Certified Geriatric Clinical Specialist, AIB-VRC

Owner: Healthy Aging Physical Therapy

I’ve been meaning to write this for a while.

As a physical therapist, I’ve met so many patients - especially older adults - who are frustrated, scared, and worn out from trying to get help for their dizziness. Many have already been to the ER or seen their primary care doctor. They’ve had bloodwork, imaging, and hours spent waiting, only to leave with a discharge summary (and costly bill…) that says "vertigo" and a prescription for meclizine (which, by the way, is often the worst thing you can do for vertigo!). 

Dizziness can be hard to describe, hard to diagnose, and hard to treat without the right tools. And most healthcare providers, despite their best intentions, do not have the training to effectively treat dizziness. Causes of dizziness in older adults can range from simple ‘plumming’ issues like Benign Paroxysmal Positional Vertigo (BPPV) to complex, multifactorial dizziness that can really limit an individual's ability to live their lives the way they want to and can lead to a cascade of other problems, both physical and emotional, down the road. Fortunately, truly dangerous causes of vertigo are actually pretty rare, and vestibular therapists like myself are trained to screen for them - and can do so, right at home. 

Last week, I completed an advanced Vestibular Rehabilitation course through the University of Pittsburgh’s Department of Physical Therapy - a detailed update on the science of dizziness, its causes, and effective treatments. It gave me the final nudge to write this, because the truth is:

Dizziness is common - but TREATABLE!

What is the Most Common Cause of Dizziness?

You may be surprised to learn that one of the most common causes of dizziness in older adults is BPPV (benign paroxysmal positional vertigo) - and it’s often misdiagnosed or missed altogether.

In fact:

• Dizziness is one of the top 3 reasons older adults seek emergency care.

• It accounts for ~10% of all ER visits in people over 65.

• Approximately 40% of dizziness in older adults can be attributed to BPPV - and many go undiagnosed for years.

BPPV is caused by tiny calcium carbonate crystals in your inner ear - called otoconia - that get dislodged and move into the wrong part of your vestibular system. This sends confusing signals to your brain, causing that awful spinning sensation when you move your head a certain way.

But here’s the key:
BPPV is both benign and highly treatable. (Really  - it’s in the name!)

Using a gentle series of head movements called canalith repositioning maneuvers, we can move the crystals back to where they belong, most often in just 1 or 2 sessions.

What If It’s Not BPPV?

That’s okay too. Vestibular therapists are trained to assess and treat a wide range of dizziness causes - including vestibular hypofunction, central dizziness, post-concussion syndrome, cervicogenic dizziness, and more.

Treatment often includes a combination of:

• Vestibular exercises designed to retrain the brain and inner ear to work together again. These may include gaze stabilization exercises (teaching your eyes to stay steady while your head moves), habituation exercises (gradual exposure to movements that trigger symptoms to reduce sensitivity), and substitution strategies that help your body use other senses like vision or proprioception to compensate for balance loss.

• Balance training that challenges your body safely to improve stability, confidence, and coordination. This may include:

• Standing on uneven surfaces

• Practicing turning or head movements during walking

• Dual-task activities to mimic real-world situations (like walking while talking or carrying something)

• Education is one of the most powerful parts of therapy. As vestibular specialists, we help you:

• Understand why you're dizzy

• Identify what makes your symptoms worse

• Learn how to gradually return to daily activities

• Build confidence to move again (because the fear of dizziness can often be just as limiting as the dizziness itself)

We also spend time helping you avoid common pitfalls - like over-relying on meclizine or stopping movement altogether, which can actually make symptoms worse over time.

We don’t just guess - we test.
Using clinical tools and evidence-based screening, we assess your vestibular system, visual tracking, balance strategies, gait, and postural control. From there, we create a personalized plan that meets your needs and goals.

Vestibular rehabilitation therapy (VRT) is the gold standard for managing most non-life-threatening vestibular disorders, and it has strong research support behind it.

Isn’t Dizziness Just a Normal Part of Getting Older?

One of the most harmful misconceptions I hear from patients is they brush off dizziness as part of aging, or are told by well-meaning healthcare providers to simply drink more water.  But dizziness is not a normal part of aging, and when it goes untreated, it can trigger a cascade of issues that affect nearly every aspect of a person’s health. People often start avoiding certain movements or situations that provoke symptoms, which leads to reduced physical activity, progressive muscle weakness, and worsening balance. This in turn increases the risk of falls, leads to  social withdrawal, and contributes to emotional challenges like anxiety and depression.

In fact, dizziness and anxiety are closely linked; research shows that the brain regions responsible for balance and emotional regulation are deeply connected. So yes, while dizziness can make you feel anxious, anxiety can actually make you feel dizzy! It’s a real, bi-directional cycle that many people find themselves stuck inW.

That’s why early treatment is so critical. A 2023 study of over 800,000 adults found that individuals who received physical therapy within three months of reporting dizziness were 86% less likely to fall in the following year. That’s an extraordinary impact, and a clear message that getting help early matters. Don’t wait to see if it goes away. There’s effective treatment available, and it can make all the difference.

The Benefits of At-Home Vestibular Care

When you're experiencing dizziness, just getting to a clinic can feel overwhelming, dangerous or impossible. You may be facing challenges like driving, navigating stairs, fatigue, or simply not having someone available to accompany you. BPPV treatment may leave you feeling dizzy for an hour or so after they are complete, so getting home from the clinic may be an unexpected challenge as well.  That’s why we bring expert vestibular care directly to you. At Healthy Aging Physical Therapy, we provide outpatient-at-home vestibular rehabilitation—a safe, effective, and personalized approach that addresses dizziness, vertigo, and balance issues in the comfort of your own home. Our team includes certified vestibular and concussion specialists, Dr. Katie Wadland, PT, DPT, Board-Certified Geriatric Clinical Specialist,  and Jessie Jamieson, PTA, both trained through the American Institute of Balance. When dizziness is your primary concern, you’ll be evaluated by one of our vestibular-trained clinicians to ensure an accurate diagnosis and targeted treatment plan from the start.

You may also receive care by a member of our larger, collaborative team of physical and occupational therapists who have  advanced training in fall prevention, Parkinson’s Disease, orthopedic rehabilitation, chronic pain, arthritis, and post-injury recovery. That means you won’t just be treated for your dizziness - you’ll be cared for as a whole person. With at-home vestibular care from a specialized and holistic team, you can feel secure knowing you're in good hands every step of the way.

Ready to Get Steady?

Dizziness doesn't have to take away your confidence, your safety, or your ability to live life on your terms. With the right treatment, delivered by a specialized team in the comfort of your own home, you can get back to doing the things you love without the fear of falling.

At Healthy Aging Physical Therapy, we provide outpatient-at-home vestibular rehabilitation covered by Medicare Part B, BCBS and most Medicare Advantage Plans. That means you get the same expert care you'd receive in a clinic, without ever having to leave home. From your first evaluation to personalized vestibular and balance therapy, you’ll be supported every step of the way by a team who understands the unique needs of older adults.

To request a Vestibular Therapy Consultation, you can:

📞 Call us at (617) 398 - 4508
📠 Ask your doctor to fax us referral to (781) 262 3337
🌐 Or click the button below to register as a new patient and we’ll call you from there to schedule your appointment.

References

• Marmor et al. (2023). Use of Physical Therapy and Subsequent Falls Among Patients With Dizziness in the US.
   JAMA Otolaryngol Head Neck Surg. https://doi.org/10.1001/jamaoto.2023.2840

• Pauwels et al. (2023). Gait and Falls in BPPV: A Systematic Review and Meta-analysis.
   J Neurol Phys Ther. https://doi.org/10.1097/NPT.0000000000000438

• Dunlap et al. (2021). Fear Avoidance Beliefs and Disability in Vestibular Disorders.
   Phys Ther. https://doi.org/10.1093/ptj/pzab147

• Metz & Bryce (2024). Including BPPV Screening in Falls Clinics.
   J Laryngol Otol. https://doi.org/10.1017/S0022215123002049

• Agrawal et al. (2009). Vestibular Dysfunction and Fall Risk in US Adults.
   Arch Intern Med. https://doi.org/10.1001/archinternmed.2009.66

• McDonnell MN & Hillier SL. (2015). Vestibular rehabilitation for unilateral peripheral vestibular dysfunction.
   Cochrane Database Syst Rev. (1):CD005397.
   https://doi.org/10.1002/14651858.CD005397.pub4

• Bhattacharyya N et al. (2008). Clinical Practice Guideline: Benign Paroxysmal Positional Vertigo (BPPV).
   Otolaryngol Head Neck Surg.
   https://doi.org/10.1016/j.otohns.2008.08.022

• Oghalai JS et al. (2000). The Dizziness Handicap Inventory: BPPV and Older Adults.
   Otolaryngol Head Neck Surg.
   (Referenced for prevalence data; original article not available online, but frequently cited in clinical literature)

The Science of Socialization

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

Owner: Healthy Aging Physical Therapy

Earlier this month, I returned from a very special trip: a full week away in Sedona with my best friends — my college roommates. Since meeting back at ‘the turn of the century’ (how ridiculous does that sound ?1?), our lives have taken us in many different directions: new careers, marriages, divorces, losses, love, babies, teenagers (😫) moves across states - even moves across oceans! And like many adult friendships, the day-to-day demands of life often mean that we go far too long without seeing each other face to face.

But no matter what else is happening in our lives, we've remained religious about one thing: scheduling our annual girls weekend. Even when it’s just a long weekend over the summer, we’ve kept the tradition alive. This year was the first time we carved out a full week — and let me tell you, it was pure magic.

More than the hikes, the incredible views, or the late nights laughing until we cried, what made it so meaningful was simply the connection. That feeling of being truly known, truly supported, and truly in the moment with people who have walked beside you through all of life’s changes. And it reminded me how critical — and how scientifically essential — social connection is for our health.

What Happens Inside Your Body When You Connect

When we connect meaningfully with others, it’s not just a "nice feeling" — our bodies actually respond biologically:

• Oxytocin, sometimes called the “bonding hormone,” is released, promoting feelings of trust, belonging, and relaxation.

• Levels of cortisol, our main stress hormone, decrease when we engage in positive social interaction, helping reduce inflammation and boost immune function.

• Dopamine and serotonin — the "feel good" neurotransmitters — increase, improving mood, energy, and even pain tolerance.

• Meaningful social interaction can even lower blood pressure and support cardiovascular health over time.

In short, connection is not just emotional — it’s chemical. Your brain and body are wired to thrive on human interaction.
(Source: Harvard Health Publishing, 2021; National Institutes of Health, 2022)

How Our Social Networks Change Over Time

It’s also normal that how and when we socialize evolves throughout life:

• As children, friendships are constant and casual, woven into daily school and playtime.

• In adolescence, friendships intensify, shaping identity and emotional development.

• As new parents, social circles often shrink, with focus centered on caregiving and family demands.

• In midlife and later adulthood, social opportunities can decline as retirement, relocation, health issues, or caregiving responsibilities arise.

Without mindful effort, social isolation can sneak up, making connection even more critical as we age.

Why Socialization Matters for Healthy Aging

We often think about diet and exercise as the pillars of healthy aging (and they are), but strong social connections are just as essential to long-term health and well-being. In fact, research shows:

• More than one-third of adults over age 45 report feeling lonely, and nearly one-fourth of adults over age 65 are considered socially isolated.

• Loneliness is often considered as harmful as smoking 15 cigarettes a day and raises the risk of heart disease by 29% and stroke by 32%.

• Social isolation significantly increases the risk of premature death from all causes, comparable to risks posed by smoking, obesity, and physical inactivity.

• Older adults with strong social ties have better cognitive health, lower depression and anxiety rates, and stronger physical health overall.

(Source: National Academies of Sciences, Engineering, and Medicine, 2020)

The simple truth is: connection heals. It protects, energizes, and helps us live not just longer — but better.

Small Steps to Build (or Rebuild) Your Social Connections

If you’re feeling the need for more connection in your life — you're not alone. And it’s never too late to take steps to strengthen your social well-being:

• Reach out to an old friend you haven't spoken to in a while.

• Join a local class or club that sparks your interest — fitness, art, volunteering, book clubs, or travel groups.

• Explore virtual communities if distance or transportation is a barrier.

• Schedule regular get-togethers, even if just for a coffee or walk.

• Be open to making new friends — every stage of life can bring new connections.

Just like exercising your body or eating nourishing food, tending to your social life is an important part of caring for your health.

As I was reminded during my week in Sedona, it’s not about where you go — it’s about the people you walk beside. Connection is a vital ingredient in the recipe for healthy aging — and one of the most joyful, too.

The Healthy Aging Difference: How Our Team Culture Transforms Patient Care

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

Owner: Healthy Aging Physical Therapy

Not our hands…or our sweaters 🙃

Why I Call our Staff my 'Team'

When I first started hiring therapists to join me at Healthy Aging Physical Therapy, I had a vision for something different. I never wanted a traditional workplace with a rigid hierarchy where a boss dictates orders and employees follow along. That just didn’t sit right with me (also, seemed kinda lonely…). Instead, I imagined a co-op-style environment—one where we all work together, share responsibilities, and create a thriving ecosystem of care, both for our patients and for one another.

I wanted to create an environment without closed-door meetings or red tape, with a culture of transparency and kindness where we could work together through challenges and also celebrate our wins. While I didn't know exactly what I was doing in many ways, I felt pretty clear in this path, and I’ve found that this philosophy has shaped how we operate and led to strength in our reputation. We all contribute to both our wins and our challenges, and that philosophy has shaped everything about how we operate.

From the very start, I made conscious decisions to build a workplace culture that reflects this team-oriented approach:

• Our meetings aren’t “Staff Meetings” — they’re Team Meetings because we all have a seat at the table. We meet not only to review updates and discuss patient care but also to review practice finances as a team so we are all on the same page. We take turns teaching each other—sharing responsibilities for monthly in-services and journal reviews.

• Our 1:1 meetings aren’t “Performance Reviews” — they’re Mentorship Meetings, focused on growth, not judgment. They’ve become a time to check in, to see how things are going both professionally and personally, and set goals together to move forward over the next year.

• Our compensation model isn’t based on traditional raises (which are often either absent or so small they barely feel meaningful in healthcare). Instead, we have a profit-sharing bonus model where all disciplines (therapists, trainers, office managers) share equally in our collective success—because we’ve worked equally hard to get there.

• I support and encourage co-treats, shadowing, and other learning opportunities as paid time so we can learn from each other, improving patient care and learning from our best resources — our own teammates.

Over the past five years, these intentional choices have evolved into a culture that I am so grateful for—one that I can feel in every interaction with our team and our patients. But what’s even more incredible is that this culture isn’t just a feeling anymore. It’s showing up in tangible, objective ways, and I see it every single day in the way our team steps up for each other and our patients.

Here are just a few ways I've seen this team-oriented culture manifest:

• Leveraging Each Other’s Strengths – Our clinicians actively seek each other out for consults and co-treats, ensuring that every patient gets the benefit of multiple perspectives. Some of our therapists are ortho rock stars, while others (ahem…me) are more specialized in neurorehab, wheelchairs, and vestibular therapy. Instead of staying in our silos, we share our knowledge so that we all grow professionally — and our patients receive the best possible care.

• Going Beyond Patient Care – I often overhear (or 'over-read' in our chats and emails) that our therapists go above and beyond their typical duties. Our therapists frequently step in to help with office tasks and phone calls, and they take the time to care for their patients in ways beyond the duties of therapy. Whether it's taking the time to water their plants each week, bringing holiday-themed decor to use for balance activities, or spending those extra few minutes to really get to know their to patients, these are the skills you don't learn in school — but they are the qualities that make the Healthy Aging experience so special.

• Sharing Knowledge – Whether it's helping a teammate learn to write a letter of medical necessity, sharing resources, or meeting up for a “pizza and transfers” party, our therapists share their time and knowledge because they want to improve their skills for their patients and learn from each other.

• Supporting Each Other in Good Times and Bad – Whether it’s celebrating a wedding, a new baby, or supporting a team member struggling, I've seen our therapists organize gifts and care packages. They cheer each other on when someone earns a new certification or reports a 'win' with a patient. Small gestures like this make a big impact and reinforce that we are more than coworkers—we are a team that genuinely cares about each other.

• Stepping Up When It Matters – When someone on our team is sick or on vacation, others jump in to cover patients outside of their usual territories. There’s no grumbling, no reluctance — just a shared commitment to making sure our patients receive consistent care.

What This Means for Our Patients

All of this translates into amazing patient care. When a team operates with trust, collaboration, and mutual support and respect, this gets passed on to the patient experience. They receive more comprehensive, well-rounded treatment, benefitting from a group of clinicians who are constantly learning from and helping each other. I say it all the time, and I truly mean it—happy therapists = happy patients.

While our model is rooted in 1:1 patient-centered care, what many don't realize is that behind that '1' is 18 teammates working together to encourage their success. And that’s what makes Healthy Aging Physical Therapy different. And the results speak for themselves — just take a look at some of our recent testimonials and reviews from our Healthy Aging community!

Want to Join our Team? We’re always in search of amazing Physical and Occupational Therapists, and Personal Trainers ready to do things differently. Check out our Careers page to learn more, or submit your application by clicking below!

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.