The Joint Ventures' Blog

A Weight-Neutral Approach to Physical Therapy

Friday, March 12, 2021

Have you ever gone to a healthcare professional for help and left the office feeling worse than when you went in due to the practitioner blaming your discomfort solely on your weight?

People of larger body size frequently report similar experiences.

Visiting a healthcare provider doesn’t have to be an anxiety-ridden experience. There is a more inclusive, accepting way to treat patients of all shapes and sizes. Health At Every Size (HAES) is a health initiative/model that is body-inclusive. It takes the focus of health from being weight/size-centered and shifts the focus to making healthy choices based on internal body cues. Interestingly, research over the past 20 years has consistently shown that health measures (blood pressure, cholesterol levels) can be improved with healthy behaviors regardless of whether there is a change in weight. It reframes lifestyle from dieting and/or excessively exercising, to listening to internal hunger/fullness cues, and reframing exercise to be joyful movement instead of something that you must do even if you dislike it. By doing this, people tend to become much more consistent with food intake as well as participation in exercise which in turn contributes to improved health.1

Media and societal beliefs have created and perpetuated stereotypes about people of size that are simply untrue which contribute to feelings of shame associated with larger body size. These stereotypes carry over into the medical community. Frequently, people of higher weights go to the doctor, and are told that everything from high blood pressure to a hangnail is because of the extra weight they carry. They are then given a prescription for weight-loss and are sent on their way. This "medical advice" is internalized by patients as, for example, "I'm lazy; I don't care about my health; it's my own fault that I have *insert medical condition*". People leave the doctor's office feeling despondent and deeply ashamed of themselves with no new or helpful information, so they avoid seeking healthcare. What is worse is that when they do seek out care, because healthcare professionals tend to blame so many ailments on weight, they're often misdiagnosed or dismissed which can lead to worsening health conditions or even death.

I have a personal connection to HAES. I am a larger-bodied physical therapist who has been following its principles and practicing intuitive eating for 2-3 years. I have since been able to stop the vicious restrict/binge cycle of disordered eating, and have become consistent with movement multiple times a week. I now enjoy exercise because I view it as a way to give my body the movement it craves instead of viewing it as a punishment for its size/shape. I have also experienced doctors giving me a blanket prescription of weight-loss for seemingly any ailment. It can be very frustrating and demoralizing, and I have often avoided seeking treatment in fear of ridicule or shame.

This is why I value incorporating what I have learned through practicing HAES and intuitive eating in my personal life into my treatment of patients. I am someone who people of all shapes and sizes can come to without fear of judgement or prescription of weight-loss to solve whatever pain they may be having. As PTs we have the knowledge to modify exercises appropriately so that everyone can participate and benefit. I hope to be a source of support for people who have avoided seeking care in the past so that regardless of size, they can work feeling better in the body they have right now.

For my information on Physical Therapy and Health At Every Size, email our Fort Point PT, Molly Durigan.




1.Bacon L. In: Health at Every Size: the Surprising Truth about Your Weight. Dallas, TX: BenBella Books; 2010:167-169.


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Management of Labral Tears in the Hip and Shoulder - Should surgery still be the gold standard?

Monday, August 24, 2020


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Why Do I Have Elbow Pain?

Monday, February 24, 2020

There are a lot of potential reasons that your elbow may be bothering you. Examples of causes of elbow pain include acute trauma (a fall on your arm, dislocation, fracture), nerve entrapment (cubital tunnel syndrome, radial tunnel syndrome), or arthritis (osteoarthritis, rheumatoid arthritis). Your physical therapist will consider your mechanism of injury, behavior of your symptoms, and past medical history in conjunction with a movement assessment to help determine the root cause of your elbow pain.

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New Year, No New Injuries! Tackling New Year Fitness Resolutions

Friday, January 03, 2020

At the start of the new year, it’s common to want to return to exercise and going back to the gym. After taking some time off, whether it’s been years, months, weeks, or days it’s important to get back on track. Here are some tips for your most successful year yet!

Set yourself up for success: Having a general “get back to the gym” goal can be daunting. Setting smaller achievable goals can help you achieve that long term goal and stick with it. Try setting specific, measurable, achievable, relevant, and time based goals, or ‘SMART’ goals.

Warm it up: Before you jump in, try a 5 to 10 minute warm up to get you prepared for activity. Save the stretching for after, instead opt for an active warm up to promote dynamic stretching to start. Try to incorporate as many body parts as you can to maximize your efforts. Some examples include light biking or walking, jumping jacks, inchworms, or walking leg kicks.

Change it up: Keep it fun to keep it interesting! Not all exercise has to be boring, if you don’t like plain cardio exercises, try strength training movements. Studies show combined cardio and strength exercises are more effective than one on their own.

Be Smart: Try the tips below to prevent injuries:

-Start at an appropriate level of challenge. Whatever weight or resistance you start at should feel challenging, but not so much that you are not able to complete more than a few repetitions. The last repetitions should feel difficult. If it feels like you do not have control or are able to complete the activity without changing your form or compensate in another way, try the level or weight below and work your way up.

-Progress resistance and/or difficulty once you feel comfortable, especially if it is a new exercise or type of exercise.

-Be consistent, but don’t overdo it. Build towards mileage, repetitions, and/or time exercising.

-If you are exercising outside, wear appropriate layers and/or equipment.

-Make time to warm up before and cool down after exercise.

Rest and Recover: After exercise, it is normal to feel sore and tired. Exercise creates changes in body temperature, energy expenditure, heart rate, respiratory rate through muscular contractions. Always make sure to improve your recovery with a cool down to gradually decrease heart rate. Follow this up with stretches to improve and maintain your range of motion and muscle relaxation.

Stay Fueled: Make sure you sustain yourself with enough food and fluids. Support your loss of fluid and prevent cramping and dehydration. With your increased energy demands, it is important to make sure you are eating enough to have enough energy to sustain your output.

Blog by Stephanie Lee, PT, DPT located at our Downtown clinic.


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Physical Therapy vs. Surgery: What One Research Study Finds and Thoughts From a PT Perspective

Thursday, October 24, 2019


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Resistance Training Basics

Thursday, September 26, 2019

When we think of resistance or weight training, it probably means somewhat different things to each of us.Resistance training encompasses a wide range of specific effects to our neuromuscular system.You may be interested in developing explosive power, building muscle mass or strength, more endurance, or just trying to stay strong for the demands of your daily activities. Depending on what your fitness goals are, you will benefit from a specific program targeted at meeting those goals.And whether you are new to resistance training or have been doing it for a while, there are some basic principles to follow that can be helpful in maximizing the results from your training.

There are numerous factors and variables to consider with resistance training.These include an individual’s level of experience and history with resistance training, the amount of weight lifted, the speed of the movement, the number of sets and repetitions performed, the duration of the rest period between sets, and the frequency of lifting sessions.There many ways to manipulate these variables to have an impact on the training effect.The purpose of this blog post is to go over some of the basics of resistance training with an emphasis of proper weight/load and repetition selection.

One of the most important principles of resistance training is proper load selection.The number of repetitions that can be performed is inversely related to the load lifted.This means that the heavier the weight, the fewer the number of times it can be lifted.Manipulating the load is a very important consideration in resistance training and by doing this, you are able to target a specific training effect.The specific muscle adaptations to target with resistance training are muscle endurance, hypertrophy/muscle mass, strength, and power.

Whatever your desired training goal is, you want to find the load that allows to work in the targeted repetition range.This is important to fully maximize potential results from training.Since everyone is different, the proper weight selection will take some trial and error.If your goal is to build muscle endurance, you want to target a load that you can perform for 2-3 sets of 12-15+ repetitions with 30-45 seconds of rest in between.If you want to increase muscle hypertrophy or size, you should perform 3-5 sets of 8-12 repetitions with 60-90 seconds of rest in between.If the goal is to build muscle strength, 3-5 sets of 4-8 repetitions with 2-3 minutes of rest in between is recommended.Muscle power exercises are more technical and require a lot of skill and coordination. The load will be lighter due to the emphasis on the explosiveness and speed of the movement. You would perform 3-5 sets of 3-5 repetitions with 2-4 minutes of rest between sets.These are general principles and there is plenty of room for variability.

Training Goal   # of Repetitions # of Sets Rest Period
Muscle Endurance 12-15+ 2-3 30-45 seconds
Muscle Hypertrophy 8-12 3-5 60-90 seconds
Muscle Strength 4-8 3-5 2-3 minutes
Muscle Power 3-5 3-5 2-4 minutes

Once you find the proper load to lift and begin training towards your goals, it is important to know how to progress the resistance as you are able.Whatever the training goal is, the effort level should be moderate to high and you need to consistently assess ability to meet the targeted repetition range.The neuromuscular system responds to progressive loading and without an appropriate training stimulus continued muscular adaptation will be minimized.

So, how do you know when you should increase the weight you are lifting to keep progressing towards your training goals? A good general rule to follow is that if you are able to perform 2-3 sets of an exercise at your desired repetition range for your training goal and at the end of the last set you feel that you can perform an additional few repetitions without compromising technique, you can increase the resistance and continue along with that approach.

The world of resistance training has many facets and there are many variables to manipulate to maximize the potential to meet your goals.There is a lot of information out there and it can be overwhelming.The purpose of this blog was to provide some general information and by no means does it address all potentially relevant aspects of resistance training but hopefully it gives some helpful information and guidance that will be useful to your fitness goals.If you would like to learn more, please to stop by the Downtown Office or email Dave Carleton at



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Gait Analysis

Friday, June 28, 2019

With the weather finally warming up in New England it is time to transition working out in the outdoors. Soon we will see the esplanade fill up with bikers and runners. Spring and summer are a big transition for our patients at Joint Ventures. Trading the sturdy winter boots for flip flops and running shoes can take a toll on your unprepared feet. The increase in activity along with the lack of support can cause many seasonal feet diagnosis such as plantar fasciitis or achilles tendinitis. But this transition is something we should be able to carry on through granted our feet are prepared for it. One topic that is important to talk about is gait mechanics. Whether we are walking or running the biomechanics and foot strength can be critical for injury and pain prevention as we hit the pavement or sand in these upcoming months. The quality of movement during a walking or running cycle can give us a lot of information about these common feet diagnosis. Evaluation through slow motion analysis as will be further discussed below shows a glimpse of what were are looking for during a treatment session. 

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Why Am I Dizzy? A Brief Overview of Vestibular Disorders

Friday, May 31, 2019

Have you ever experienced dizziness, vertigo, or loss of balance? Most people do at some point in their life, and many times, it goes undiagnosed or dissipates quickly enough that it cannot be detected at the doctor’s office. 

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What is The Sacroiliac Joint (SIJ)?

Tuesday, May 07, 2019

The sacroiliac (SI) joint is one of the more controversial and debated joints in the PT world. Topics of debate include:  

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Pilates: What's All The Fuss About?

Monday, April 01, 2019

Many of us have been at our gyms, in our homes, or at a doctor’s office and seen advertisements for Pilates classes or private sessions. We have heard of its health benefits on television shows like Good Morning America (1) and in magazines like Time (2). Pilates seems to be everywhere…but why? 

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