Geriatric Physical Therapy

Tim McCullough worked for world renown Geriatric Physical Therapist Carole Lewis  for 3 ½ years. She is the past owner of Premier Physical Therapy and author of a top selling book " Age Defying Fitness". Tim learned from Carole that age does not limit one's ability to be strong, productive, and athletic. She was active in geriatric research and owned her own seminar and publishing company, "Great Seminars and Books."  Under Carole's mentorship Tim learned how to effectively treat the geriatric population. He learned the importance of staying on top of the latest treatment and assessment techniques in the field of Physical Therapy. While working with Carole, Tim helped in the production of Physical Therapy Publications (Orthopedic Flash Cards and others) and was an assistant at one of her excellent seminars.


"Tim is terrific with young athletes, but he's also especially skilled and empathetic with older clients.  My husband, in his late seventies, was having increasing trouble walking, and was diagnosed with nerve damage to his legs from radiation therapy.  The neurologist said physical therapy would be useless, and offered to write a prescription for a motorized scooter. But our internist referred him to Tim, and my husband had a dozen more happy years, striding briskly with the aid of a snazzy rolling walker, and even walking the length of the corridor and around our home on his own.

He is great with young clients, with athletes in their prime, and with older people like me and my husband, who found new strength, confidence, and mobility in our eighties and nineties."

Gay Hammerman click for full testamonial




Headaches are often caused by disorders of the neck or physical and emotional tension. Studies show that cervical headaches account for between 15% and 20% of all chronic and recurrent headaches. Cervical headaches stem from musculoskeletal dysfunctions that include abnormal upper cervical joint mobility, trigger points in the cervical muscles, and decreased strength and endurance in the deep cervical flexors. Cervical headaches are the most common persistent symptom following neck trauma; poor sitting posture and stress are also often associated with headaches of cervical origin.

Tim has significant training in treating headaches and helped teach a course on headaches with his mentor Peter Boyle.

SMART PT's approach to treating headache

The successful management of headaches relies on an accurate diagnosis of their origin. At SMART PT, we evaluate your symptoms and look for patterns that indicate the cause of your headache.  Depending on the cause of your headache, your therapy may include:

  • Joint mobilization, especially in the upper cervical spine, to increase Range of Motion
  • Soft tissue manipulation or release to decrease muscle tightness, and release musculoskeletal trigger points to restore pain-free cervical mobility
  • Instruction in relaxation techniques and proper Diaphragmatic breathing
  • Education about posture and movement to restore neutral joint and muscle position at rest and to facilitate pain-free and stress-free movement patterns.  Getting head control with the local muscles of the neck.
  • Self-mobilization and exercises designed to help you maintain normal, pain-free mobility and function.


"I have been suffering for many years with headaches, jaw pain, dizzy spells, and severe neck problems.  I met Tim about a year ago after many years of trying to find something that would help my pain.  When I first met Tim he recognized my dizziness issue right away and believed we could carefully treat the neck and jaw without aggravating the dizziness, and that maybe the neck was involved in my dizziness problem.  My severe neck and jaw problems were from a severe car crash and a bus accident in grammar school when I hit my head.  He explained to me how head injuries can cause the upper neck joints to work incorrectly and could lead to the symptoms I was experiencing in my head, jaw and neck.  The techniques Tim did in Physical Therapy were gentle and they helped my neck and jaw pain quite quickly.  The amazing surprise is that the treatment also helped my chronic dizziness.  Tim knew from the beginning that his would likely help because of the abnormal alignment or movement in my upper neck from his testing me the first day.  I had gone to a chiropractor but he was never able to get to the main problem.  Tim added some gentle exercises to help me keep the improvements in motion and strength and helped me improve my posture.

I am so happy I met Tim because today I am free of dizzy spells and my neck and jaw do not bother me anymore."


Colleen Chase


Fibromyalgia is a chronic condition characterized by widespread pain in muscles and joints, particularly in the neck, spine, shoulders, and hips. Because its symptoms are common to many other disorders, it is difficult to diagnose-a situation that frustrates patients and physicians alike.

Although not much is known about what causes this syndrome, we do know that it may be triggered by physical or mental stress, inadequate sleep, an injury, exposure to dampness or cold, or certain infections.

Common symptoms

The most common symptom of fibromyalgia is pain. In addition to pain, other symptoms include:

Moderate to severe fatigue

Sleep disturbances (limited duration, poor sleep habits, and frequent interruptions

Difficulty concentrating

Numbness and tingling

Headache and facial pain

Bowel or bladder spasm and irritability or control issues

SMART PT'S approach to treating fibromyalgia

SMART PT's treatment of fibromyalgia helps relieve pain, restore function, relax you, and empower you to self-manage your condition. Your treatment may include:

1. Therapeutic exercises to increase aerobic capacity and improve the efficiency of the postural muscles (the gravity fighting muscles)

2. Body mechanics and posture training to learn to move efficiently

3. Instruction in breathing and relaxation techniques for pain relief.

4. Stretching and manual therapy techniques as indicated for pain relief and self management.

5. Modalities such as heat and massage for pain relief

6. Education about ways to reduce stress, practice good sleep habits, and maintain a healthy lifestyle.


7. Pain education to reduce fear, improve the understanding of how the body responds to chronic pain, and to instruct


patients on the best coping strategies for their pain


"Tim is a talented physical therapist who is creative, patient, and caring.  I value and respect his judgement and input.  He has expertise in the management of a wide range of conditions, from osteoarthritis and rheumatoid arthritis to degenerative disease of the spine to fibromyalgia.  He is a skilled Manual Therapist.  He is excellent at communicating with patients and referring health care providers.  Patients feel comfortable working with him, and a number who expressed skepticism about PT based on prior experiences changes their minds after working with Tim.  He doesn't shy away from individuals with more difficult or chronic medical problems."

While I was sorry to see Tim move away, I am excited that he will have the opportunity to have his own practice.  I strongly recommend that you refer your patients to him for the excellent physical therapy care that your patients deserve."

Susan Lacks MD  click here for full testimonial

"I am a rheumatologist in Bethesda MD, and when Tim McCullough PT was working in Washington DC, we shared a number of patients.  Tim was particularly good with my most difficult rheumatology and hypermobile joint patients. He was particularly professional and receptive to the patients' needs, as well as being an effective physical therapist."

Russell Rothenberg, MD

TMJ Dysfunction

The temporomandibular joint (TMJ) is where the skull's temporal bone connects to the lower jaw. This joint opens and closes like a hinge and slides forward, backward, and side to side. Temporomandibular joint dysfunction occurs as a result of anatomic problems within the joint or tension in the muscles surrounding it.


Signs and symptoms of TMJ dysfunction include:

Pain in the jaw that accompanies movement, clenching, and pain waking in A.M.

Decreased range of motion in the jaw

Noise during jaw movement

Headache, neck and ear pain

SMART PT's approach to treating TMJ dysfunction may include:

Manual therapy to increase range of motion in the TMJ region, recapture the displaced TMJ disc, decrease muscle tightness, reduce stress to the jaw joints, and release musculoskeletal trigger points to restore pain-free mobility

Education about posture and movement to reduce inflammation within the joint, regain harmony in the jaw and muscles, improve function and range of motion, and stabilize the bite and TMJ in a physiologic position Self-management activities designed to help you maintain normal, pain-free mobility and function.

"Over the years I had the pleasure of working with Mr. McCullough ("Tim"). He was one of few physical therapist I encountered that had such an extensive knowledge of TMJ and craniofacial rehabilitation. He worked with my pre and post surgical TMJ and orthognathic surgery patients. He also assisted with non- surgical patients with chronic craniofacial and TMJ pain. My only regret is that Tim moved to NH. I highly recommend him."

Robert Emery DDS

Diplomate American Board of Oral and Maxillofacial Surgery