Client Win Wednesday

ICYMI, I’m thrilled to welcome Dr. Catherine Clements, chiropractor and Pilates instructor, to the Align team!

Dr. Catherine brings years of experience, a whole-body approach to healing, and a deep dedication to her clients' growth and recovery. Whether you're looking for support with scoliosis, injuries, chronic pain, or simply want to move better and feel stronger, she offers something truly unique — the rare combination of clinical precision, intuitive insight, and heart-led care.

But don’t just take my word for it — here’s what her clients say:

“Dr. Catherine is one of the most intuitive and knowledgeable practitioners I’ve ever worked with... She thinks outside the box and is not one to back down from a challenge...With Dr. Catherine, you are more than your injury or diagnosis.”
— Rene M.

“She is trustworthy, honest, and extremely knowledgeable in chiropractic, scoliosis, and movement education... She gets down to business and no time is wasted! Truly one of a kind.”

— Krystal M.

“She taught me how to be gentle with my body and spine, and how to be kinder to myself... I’m so grateful for her guidance and heart.”
— Melissa I.

Dr. Catherine is now accepting new patients. If you're looking for personalized, intelligent, and compassionate care — this is your moment to book.

👉 Appointments are available Monday-Friday from 6 AM-4 PM.

Welcome Catherine to our community by experiencing the care so many clients already trust.

BOOK WITH CATHERINE

Your Body is Your Vehicle for Life

I’ll be honest — I’m not a “car person.” I couldn’t tell you the make or model of most vehicles. I usually identify them by color, and as long as a car gets me from point A to point B safely, I’m happy.

But I was listening to a podcast the other day, and something the host said made me pause. He was talking about cars, and then he said this: “Your body is your vehicle for life.”

That hit me.

Because it's true. We rely on our bodies every single day — to show up for work, to care for our families, to enjoy life. But are we giving them the care they deserve?

Imagine the difference between driving a luxury car that runs smoothly — climate control, great gas mileage, top safety features — versus clunking along in a beat-up car that leaks oil and feels like it could break down at any moment.

Our bodies are no different.

The problem is, most of us don’t do anything until the “check engine” light comes on — pain, fatigue, stiffness.

By then, it’s not just about maintenance. It’s about repair. What if you took better care of your body before it demanded your attention?

That’s where we come in. At Align, we help you feel better, move better, and live better.

Whether you’re dealing with chronic pain, recovering from an injury, or just ready to prioritize your health, we’re here to guide you — with the same precision and attention a luxury vehicle would get in the shop.

You don’t need to have all the answers. You just need to take the first step.

👉 Book your appointment with a member of our team and let’s get you running smoothly again.

See you soon, Amanda

Load Management

Over the past few years, the term and implementation of 'load management' has become popularized in the NBA.

Load management is when a healthy player is held out of playing in a game for rest or precautionary reasons. This is done for the purpose of avoiding long-term fatigue and injuries. This call is made by the athletic trainer, PT/Chiro or coach, with some input from the players themselves.

Load management is a controversial topic. Fans don't like it, because it means that oftentimes the team's best (and most handsomely paid) players are sitting on the bench for no apparent reason. If you paid to see the Lakers play at home, you'd understandably be a little ticked off if LeBron was sitting on the bench decked out in a Gucci tracksuit for "load management" reasons.

I'd argue though, that load management is important for all individuals, both in terms of too much load AND too little. The go-go-go competitive mentality of the professional athlete can force them to push beyond their physiologically limits, despite a lack of sleep and changing time zones. So, they need someone to police them a bit. This high level intensity is undoubtedly how greatness is achieved, but it takes a big-picture thinker to support an athlete through an entire career. This is why we have coaches and therapists -- to manage load.

In the everyday population, what I notice is that people are most often UNDER-loaded. They both underestimate the physical demands of their daily lives and underestimate their strength capabilities. Chronic under-load yields negative health outcomes, just like chronic overload. I can't tell you how many patients with lower back pain look at me like I have 3 heads when I ask them to squat with a 25 pound dumbbell, or deadlift for fear of pain -- but will pick up their 25 lb 2-year old from the car, the ground, the stroller etc. -- without a second thought.

Load is nothing to be afraid of; what you need to be mindful of is the appropriate amount of load for your body. To re-purpose the infamous FDR quote: "The only thing we have to fear [from load] is fear [of the load] itself.”

If you are actively participating in some form of resistance training (ie., more than bodyweight focused exercise), then I recommend you check out Sarah's Strength Club. You won't have to worry about over or under doing it - as coach, load management is Sarah's job!

It is the perfect intro or refresher to safe and functional strength training. You may surprise yourself, and realize you are MUCH stronger than you think you are. This semi-private class setting is perfect for the individual who wants the benefits of a group class with personalized instruction.

Classes are $65 per session, taking place on Tuesdays at 6 PM. There are ONLY TWO SPOTS remaining in the May series, taking place at 6 PM on May 2, 9, 16 and 23rd. Click the link below to secure your spot today!

And for those of you watching -- enjoy the NBA playoffs!

My Joni Mitchell Story

"Don't it always seem to go

That you don't know what you got 'til its gone?

They paved paradise and put up a parking lot"

Joni Mitchell's Big Yellow Taxi song took on a new significance for me this weekend re: walking. I broke my foot playing tennis on Friday afternoon, and spent most of Saturday in the Cedars ER. I heard a pop when quickly changing direction to go from a forehand to backhand, and knew right away it was broken. Complete fracture of my 5th metatarsal. ARGH.

In the minutes following my fall with ZERO ability to weight bear on my right foot, I was able to get myself up with my arms and left leg and hop to the car. What it made me think about was the importance of being able to GET YOURSELF UP after falling down. I'm not talking about the metaphorical 'pick yourself up after life knocks you down' idea (though of course that is important). I'm talking about the physical strength to get up off the ground.

We should all expect to physically fall down at some point in our adult lives. Kids are so efficient at falling down and getting back up that they don't even think about it. They just do it. But there's a certain point, a certain age -- where falling becomes abnormal, and we don't spend much time practicing how to get up from the ground. The problem is that we will all fall down again, eventually. You don't know when or how it will happen -- but it will. Bummer, but it's true.

Fall prevention is the #1 PRIORITY for older adults. Balance training, adequate footwear, and weight-bearing exercise are all recommended to AVOID falls. As therapists, we even perform special tests to assess the likelihood of a fall in an older adult. This is critical, but doesn't quite complete the full picture. We should also be learning how to navigate life IN THE EVENT that we fall down.

The timing of this fall is actually a bit ironic, because Sarah Court and I have been talking about the launch of an upcoming program: Sarah's Strength Club.

This 4-week program focuses on STRENGTH TRAINING. Namely, how to safely and effectively become stronger in all the essential movement patterns -- squat, hinge, lunge, push, pull and carry. This small group training program will meet on May 2, 9, 16 and 23 (Tuesdays) at 6:00 PM.

I am grateful for my resistance training because since this injury, I find myself needing to do a single leg squat to get up from or sit down on the toilet. I need to load one foot to transition out of a car to get my crutches. I have to single leg hop up the stairs to get into my apartment. (I go down on my butt, much less gracefully). The ER docs were VERY concerned about the notion of a pregnant lady single-leg hopping down the stairs. Psssht.

Seriously, though: EVERY SINGLE PERSON should be doing some form of resistance training to focus not only on fall prevention, but also on fall recovery. I'm not a senior citizen, but I sure as heck want to stay strong enough to be physically independent, and be able to pick myself up after falling down. Our strength naturally deteriorates as we age. The passage of time = muscle loss and atrophy. Use it or lose it!

I recommend testing yourself. When you are on the floor, how easy is it to get back up without support? Can you do it with one arm? Without using your arms at all? With one leg?

If there is room for improvement, consider participating in Sarah's Strength Club. Sarah will be sharing more details about it in the coming weeks. In the meantime, if you see me hobbling around the clinic, not to worry -- my foot may be broken, but my spirit is not. I shall overcome!

~ Amanda

Thorne Partnerhsip

When Thorne supplement company reached out to partner with Align, I was SO excited, for a number of reasons. First off, this partnership means that we can provide you all with vitamin, testing and supplementation support at a discounted rate.

I am excited on behalf of Align, too -- for Thorne to reach out to us means that we are being recognized as a leader in holistic healthcare. It's nice to be chased ;)

My last reason is a tad selfish, not gonna lie. I get a ton of solicitation emails each day from companies suggesting we peddle various products, most of which are nonsense IMO. Thorne, on the other hand, is a company that I have been purchasing all my vitamins and supplements from for YEARS (and paying full price). The other therapists and I celebrated by placing a big order and stocking up for the year — it’s the wellness provider equivalent of going out for a drink (lame, I know).

The discount gave me the opportunity to experiment with some additional products that I may not have purchased otherwise. I just got back from Austin for the SXSW Film Festival where I went to see my friend’s movie premiere! (It’s called Scrambled, it was great, would highly recommend you check it out).

I travelled with a little Ziploc baggie full of Thorne’s Daily Greens Plus supplement which I loved having. Between the movie theater popcorn and grab ’n go meals, I was grateful for a daily dose of greens and electrolytes to start my day while traveling. I just mixed it with my morning lemon water. It helped to keep my nutrition in check, my energy high, and balanced out all the (delicious) street tacos. I came back home feeling no worse for wear, even after air travel and shoddy sleep. Not to mention being 6 months pregnant.

Align clients can get 20% off of the Daily Greens Plus and all other products at Thorne. Click the link below to access the discount or search for Align Physical Therapy - just create an account and they'll ship to you directly.

-Amanda

It’s Easy To Start

Well, this is about the time of year that it starts happening. Falling off the wagon on New Year's resolutions, that is. It is a well-documented phenomena that attendance at health and wellness based businesses (gyms, yoga studios, meditation centers) all skyrocket in January of the new year, but then commitment gradually teeters off by mid-February. Next thing you know, you're buying discount chocolate and eating a pint of ice cream on Valentine's Day.

Anyway, I made a 2023 promise to myself to read one business book per week as a form of self-improvement. I started strong, and did all the prep work - there is a stack of library books on my bedside table written by ultra-successful people who wake up at 4:30 AM to meditate, workout, sauna and shower before putting in a 16 hour workday. But, like many people - I am not as dedicated as I was on January 1.

That's because IT'S EASY TO START. It's not so easy to finish. And the hardest thing is to SUSTAIN. My excuse is that the fiction books by my nightstand start calling to me, saying "Amaaaandaaaa, I'm much more entertaining than these mind numbing monologues on organizational structure and macroeconomics...". Excuses will always be there.

Rather than giving up on my 2023 goal when my self-motivation faltered, I changed tack. I signed up for a business Masterclass taught by Bob Iger, and have three more teed up with other instructors after I finish his.

I should have done this from the start. According to Gretchen Rubin's theory on The Four Tendencies (more on this at another time), I am what she calls an Obliger. Of the Four Tendencies, “Obliger” is the most common Tendency that people belong to.

The defining characteristic about Obligers is that they readily meet outer expectations, but they struggle to meet inner expectations. For instance, I would never would never miss a workout scheduled with Cole, the personal trainer at Align, but I struggle to set aside time to exercise on my own. Having an appointment makes me feel accountable to him, and our mutual agreement to 'show up' is what keeps me committed to training.

It is more expensive to go about self-improvement this way. There are plenty of free workout classes online and zero cost library books I could be reading, but INVESTMENT IS KEY for Obligers like myself. To meet inner expectations, Obligers have to create outer accountability.

If you started a health related goal that you have dropped off on this year, I recommend creating outer accountability.

To optimize your health and fitness in a sustainable way, schedule a training session with one of our trainers. They will become the face of accountability!

Sincerely,

Amanda

Do You Know Your Movement Menu?

When I first hurt my back, I was 22 years old and working full time as a yoga instructor. I was teaching a class in a hot room and popped down to give a visual demonstration of an advanced pose. King pigeon, it was called. It looks a little something like this.

My 22 year old yoga instructor spine normally would not have had a problem with this movement. I'd done it before, and it all felt fine. Not this time. As I went into the pose, I felt a sharp pinch and heard a strange sound coming from my spine. I got up slowly, and nervously finished (verbally) teaching the rest of the class. I could still walk, I reasoned, I'll just stretch it out later and I'm sure this will go away.

Flash forward: even two weeks later, I felt like I was a hundred years old. My back ached, and every inch of me felt stiff and tight.

Yoga had never failed me before. I tried every pose I could think of to stretch myself out. I went to a massage therapist and directed her to release the 'knots' in my back. I watched YouTube videos touting "THE BEST EXERCISES" to get rid of lower back pain. I went to a PT place covered under my insurance, and spent 6 weeks doing the exercise handout they gave me. I went to my primary care doctor for x-rays and an MRI, convinced that there had to be something broken or pulled in there. He told me that everything looked normal, and offered me a prescription for Oxycontin(!).

After 6 months and no progress I was frustrated, upset, and starting to lose hope.

I finally "redirected" money from my student loans to see a guy that my private yoga clients saw. I had already spent a small fortune on a variety of quick fixes, to no avail. I was ready for a new approach.

He spent more time with me than any provider had before, poking and prodding; the appointment was a full hour. He asked what exercises I had been doing. I proceeded to demonstrate countless yoga poses and stretches, as well as the 2 minute front and side planks I could hold because the first PT I saw told me my core was weak.

At the end of the visit, he advised me to STOP doing all the exercises and to regrain from demonstrating poses in my yoga classes. Just do these 3 things, he said:

• Book Openers (if you see me for treatment, you know that this is STILL one of my go-tos)

• A gentle TFL mobilization

• A breathing exercise meant to engage my transverse abdominal muscles

That was it. No more yoga. No more planks. No more self prescribed YouTube videos. "Only these 3 forever?", I asked incredulously, worried about my new reality. "For now" was his reply. This provider was doing exactly what he was supposed to do, and exactly what I do now; providing specific exercises tailored to me and my issues.

At Align, I call this process the Movement Menu.

Stage 1 of the Movement Menu: Chef's Selection / 0-4 Weeks

You eat what is presented to you. You move as prescribed. At this point, your body is only ready to tolerate a carefully curated selection of movements, and it has a LOT of dietary restrictions. During this period of time, it is best to work with a licensed healthcare provider. Your therapist is the chef; they are in charge.

Stage 2 of the Movement Menu: "Prix-Fixe" / 4-8 weeks

With a prix-fixe menu, you have a little bit more wiggle room - but not much. Maybe you have a total of 6 exercises that you are meant to do at home. You can select which ones you want to do, choose the order that you want to do them in. Still, your diet is pretty restricted. You're probably starting to feel a bit more confident in what you're eating, and feel like it's time to stray off menu. It isn't.

Stage 3 of the Movement Menu: "Dining In" / 8-12 weeks

Here, you can curate your own movement selections. Much like home cooking is healthier than ordering from a restaurant, this is the time where you are able to navigate what does/does not feel good in your body. You can build on the exercises the therapist gives you, and start to experiment. Your therapist is still creating the menu, but they've left you in charge of cooking. You are now the sous chef with a little more freedom to fool around with the ingredients.

Stage 4 of the Movement Menu: "The Cheesecake Factory" / 12-16 weeks

Who doesn't love the 20 page menu at The Cheesecake Factory?! (Personally, I find it a bit overwhelming). This is the best stage of the Movement Menu, because it means that CHOICE has returned. You've built a strong foundation up until this point and been adhering to a strict diet, so a little cheesecake won't kill you. It won't even set you back the way it used to. You know that there are healthy and less healthy options, and you can make the best movement choice for your body.

I know now that my biggest mistake back then was a combination of impatience and hubris. I expected a quick fix when there was none. I can't blame my 20-something self for trying to take the inexpensive way out, or thinking I could fix things on my own -- but I do know that waiting was costly, in more ways that one.

If you're still looking for your Movement Menu - we are here to help. Schedule with one of our therapists for an evaluation appointment, and learn about what's best for YOUR body. And with that, I'm hungry!

Until next time -- Amanda

Go THROUGH The Deer

Since I was 8 years old, my family has spent every summer in the Catskill mountains in upstate New York. It's a gorgeous area with hilly, windy mountain roads, lakes and tons of trees. There are bears, birds, fish, cows, horses - and deer. Lots of deer.

My dad is terrified of the deer, or to be more accurate, terrified of what happens if a deer rushes out onto the road while we're driving. This is fair, as deer have been the cause of many accidents in the area. They are particularly active at night, and there ain't no lights on these country roads. When I first started driving upstate, my dad made me swear that if I encountered a deer, I would drive THROUGH the deer, intentionally hitting it on impact. In a car vs. deer scenario, this is supposed to have the best outcome.

Obviously, the thought of killing a deer is not a pleasant one, and my dad has no interest in harming deer. His rightful concern was that in swerving to avoid hurting the deer, a driver could hit a tree, another car, or flip the car over, ultimately leading to a worse accident. I promised I would go THROUGH the deer.

For whatever reason, the phrase 'go through the deer' has stuck with me, and taken on a different sort of meaning. To me, it is about confronting things head on. Whether it is a difficult conversation that you're avoiding, a task that you have been putting off, a decision that you are going back and forth on -- it is in your best interest to just do the thing, even if it will be uncomfortable. Go through the deer.

Being a business owner has forced me to become a 'go through the deer' person. Left to my own devices, I would rather avoid tedious tasks or unpleasant conversations and 'swerve' out of the way --- which may serve me in the moment, but ultimately create more damage.

The same applies physically. We know that addressing an injury in its early stages has the best outcomes and more favorable prognoses.

Still, the consequences of avoidance are not always apparent at first.

"I'll start exercising in January" or "I'll give up drinking after the holidays" are both great avoidance techniques; we give ourselves the leeway to continue to make poor choices on the grounds that the eventual changes we intend to make somehow negate the consequences of our actions in the present moment.

I'm not here to take away your holiday favorites or scare you into thinking that every ache or pain demands that you need to visit the clinic immediately. But I think we can all take a moment and be honest with ourselves, and consider how our lives may be better in the long term if we simply go THROUGH the deer.

THROUGH our problems, instead of circling around them. Intentionally navigating feelings and situations that may be uncomfortable in the short term, but ultimately serve us in the long term.

For me, that white whale was getting a treatment table reupholstered in the clinic. Seriously. IYKYK. I have a tendency to put off small chores that seem more tedious than they actually are.

A couple (ok, more like 10) phone calls later, and that table is slated to be fixed this Friday! I am very proud of myself.

I invite you to consider how your life may be impacted by confronting things, big or small, head on. Said Robert Frost: "The best way out is always through."

In seatbelt safety,

Amanda

Let’s Talk About Pain

Pain is one of the most complicated, poorly understood symptoms for physicians to treat. This is in part because pain cannot be measured on any objective scale. There are no lab tests, no imaging findings, no blood work markers that allow for one person to truly understand the pain that another person is feeling.

The only measurement we really use is a test called the Visual Analog Scale (VAS), which is a subjective test that asks the patient to rate their pain on a scale of 0-10. As you can imagine, a women who has had a natural childbirth may have a different perspective on what the worst pain imaginable is, compared to a 20-year old male who has never been injured. The answers are all relative, making pain an extremely difficult thing to treat.

Over time, science has come up with ways to differentiate pain, an attempt to categorize the physiological processes that occur after injury. These categories can help determine (1) the likely severity of the pain (2) the best course of treatment and (3) what the prognosis is.

Have you ever 'thrown your back out' or woken up with a 'pinched nerve' feeling in your neck, unable to turn your head because you slept funny? This discomfort can be so overwhelming and intense that it takes over your whole world. Oftentimes though, the more severe the pain is in the moment, the faster we will see the pain dissipate. This is characterized as acute pain, and it is characterized by pain lasting for less than 2 weeks.

Next, we have chronic pain, which is normally less severe than acute pain, but longer lasting. Without the proper intervention (education, reassurance, and appropriate treatment), acute pain has the potential to turn into chronic pain.

When you think of something 'chronic', you may think of something that takes years to develop. In fact, chronic pain is pain lasting longer than 3 months. Not that long, right? That's because after 3 months, your brain has begun to anticipate, integrate, and learn pain. It is also emotionally exhausting; this bleeds into your personal life, it impacts your ability to do activities that you used to enjoy, and affects your mental health. In short, back pain isn't just about back pain. This is called the biopsychosocial model of pain.

The catch-all category for pain is called sub-acute pain, and this is the stage that we (as therapists) tend to see people the most. It's when you've waited to see if the symptoms will go away on their own, and they kind of do, but also kind of don't. You can deal with the pain, but it has gotten to the point where it is impacting your life in a negative way.

We can make significant positive changes in all 3 kinds of pain - acute, chronic, and subacute - but the nature of your pain changes the nature of the treatment.

If you are in acute pain then our top priority is pain management. Laser therapy has shown to be incredibly effective in minimizing people's pain on the VAS scale AND putting the body's natural healing process in hyperdrive, enabling them to make it through the inflammatory stage without the need for pharmaceutical intervention. (I honestly believe that if laser was prescribed with the frequency that physicians prescribe opiates to treat pain, then we'd have a whole lot less suffering in our country today - a topic for another time).

If you re in chronic pain then we need to first break the pain cycle, which gives us a neuroplastic window to make change and get stronger. Radial shockwave therapy and laser therapy can do this, changing the message that your body sends your brain. It also breaks up some of the fibrosis of the muscle tissue, which makes you a bit more malleable for movement and manual therapy (wow, that was a lot of m's).

Sub-acute pain is typically where we focus our attention on movement, mobilizations, and strength exercises. These pain management tools can be saved for a rainy day, as pain levels fluctuate.

It is difficult to watch someone in pain. The desire to heal is why we all (as therapists) chose this profession. I am happy to be able to help Align clients in new ways, using every tool at my disposal to help people get out of pain and move better. Questions? Don't hesitate to reach out. --- Amanda

Deep Tissue Laser Therapy

2023 is bringing on some exciting changes at Align! I am thrilled to announce that beginning on January 12, we will be expanding our services to include Deep Tissue Laser Therapy.

I spent a lot of time researching these latest advances in health and technology...mainly to ascertain whether or not they were full of sh*t. (We all know that so many of these things are). What I discovered is that Deep Tissue Laser Therapy is pain treatment that works, and the science behind it is fascinating.

I would be more than happy to bore you with the exact physiological mechanisms of the healing cascade (see pg. 3), but in the interest of time and the knowledge that Bill Nuy the science guy wasn't everyone's favorite TV show when they were kids...here are the important takeaways:

What is it?:

Laser therapy is a surgery-free, drug-free option for individuals suffering from both acute and chronic pain. Treatments are fast, safe, and painless.

People see results in 3 to 5 treatment sessions and can expect notable pain relief with the effects lasting longer after each treatment -- meaning the effects are layered/compounded.

How it works:

Laser therapy is a medical treatment that uses focused light to stimulate a process within the cell called photobiomodulation(PBM). During PBM, the light interaction triggers a healing biological cascade of events that leads to an increase in cellular metabolism and a decrease in both pain and inflammation.

Who Likes it?:

Laser therapy is endorsed by professional clinical organizations including the World Health Organization (WHO), American Physical Therapy Association (APTA), and the International Association for the Study of Pain(IASP®) with over 3,000 research studies having been conducted in the field. Pro sports teams and high level athletes swear by it for recovery and rehab.

Want to try it? Inquire today.

Lessons Learned From a 7-Year Old

When I was in graduate school, a guest lecturer named Lauren started teaching our orthopedics class. Her topic was pediatrics. Lauren herself worked with a unique population: special needs pediatrics.

I was particularly interested in this section of the course, because my dad is a pediatric occupational therapist who works with developmentally delayed children in the New York public school system. I always went with him on 'take your daughter to work day' (it was waaaay more interesting than my mom's finance job in Midtown Manhattan). I didn't plan to work with kids, but always found the cases fascinating.

Dr. Lauren described the population of children and adolescents that she saw for care; primarily kids aged 4-18 with cerebral palsy, autism spectrum disorder, paraplegia and quadriplegia.

One day in class, Dr. Lauren presented an interesting case study: a 7 year old boy named David with cerebral palsy and autism spectrum disorder, non-verbal. He had been seeing Dr. Lauren for over a year for care. He had come to trust her and enjoyed their appointments together.

Dr. Lauren shared that recently, David came into her office in a wheelchair. He had never needed one before. He had to crawl up the stairs to her office and was dragging his legs behind him, barely using them. The question she posed to us students was: what could possibly cause a 7 year old boy, who just last week was fully mobile and able to walk on his own, to suddenly stop being able to use his legs?

The assignment was to come up with differential diagnoses to what could cause this sudden regression, and how/if we could treat it. Since this was something that actually happened, Dr. Lauren would respond to the best of her recollection.

We asked question after question, spitting out differentials - spinal cord infection? No. Blood work was negative.

Trauma? No evidence of a fall, and all imaging had come back normal.

Child abuse? Perhaps. But Dr. Lauren had been working with the family for some time, and never found any evidence to suggest he came from something other than a loving home.

What did the pediatrician say? Well, sometimes children can go through developmental regression periods, and perhaps David was just acting out. With no evidence of illness or injury, they could take him to a child psychologist or 'watch and wait'.

We concluded that it had to be some kind of nerve compression. But what was the cause?

As a non-verbal child, David couldn't share what his legs felt like, if he was in pain, when he first noticed it, if it was progressive or sudden, if anything made it worse or better.

All questions needed to be directed to the child's parents. The parents couldn't think of anything that would have caused it, as their son hadn't been doing any physical activity that was different than his 'usual'. The physical exam was also very limited.

My classmates and I were stumped. In Year 2 of school, our knowledge base was limited, and 'outside the box' thinking hadn't really started yet. If it wasn't on our list of conditions and syndromes, we didn't know what the heck was going on.

Dr. Lauren let us wear ourselves out with guesses, and then shared what she discovered.

After careful questioning of his parents, Dr. Lauren learned that while he hadn't done any new physical activity, they had been trying to toilet train him. To do that, he was made to sit on the toilet for prolonged periods of time to condition him to go there whenever he got the urge.

Turns out that sitting on the toilet for hours at a time severely compressed his sciatic nerve. So, David's legs basically fell asleep!

His parents felt terrible. They hadn't thought the toilet training was relevant, and were uncomfortable when Dr. Lauren started asking questions about their sons bowel and bladder movements. Her office had mainly been a place where he would go to move and to play, not a typical 'doctor's office'.

They also had no idea that this method of training training was the cause of his issue, because it was progressive. It happened over time. David was never able to adequately recover because of course, he was doing this for hours a day every day.

(While it sounds mean, it actually is a tactic that some families in situations like David's are advised to use when children are toilet trained later in life.)

My mind was blown by this case study. This hadn't occurred to me, or to any of my classmates.

Granted, Dr. Lauren worked with a population that we did not. She had specialized in pediatrics and then gone on to learn more about working with children with developmental disabilities. She was far more prepared to encounter a child like David 10 years into her career.

Still, I will never forget that class. What it taught me is that every single detail of a person's life can be relevant to a diagnosis, and it is about asking the right questions. It's also about being humble when you are unsure, and seeking opinions and referrals from others. Aspiring to be the best is about recognizing your own shortcomings and knowledge gaps. The patient comes first. Ego has no place in medicine.

Whenever I am stumped about a case, I think about Dr. Lauren and David, and it reminds me to keep digging until I get my answer.

-Amanda

Your Choice is Your Voice

I've noticed something about food advertising lately.

It's changing.

People are starting to make better choices when it comes to their health. They're asking questions about the source of their meat and poultry. They are avoiding processed foods and rejecting the snack industry, choosing instead to consume nutrient dense foods that don't have 10+ ingredients listed on the label - because an avocado is made of nothing other than an avocado.

Advertisers are getting desperate. They're adding 'gluten free' labels to foods that never had any gluten to begin with. Labels are changing colors to whites and earth tones to convey the idea of 'health', and even adding '50% less sugar!' stickers to products. It makes you wonder: if you can take HALF of the sugar out of something and have it still taste good, how much was there in the first place?

I grew up with Nutri-Grain bars and Fruit Snacks packed into my lunch box along with slices of American cheese, individually wrapped in plastic. That stuff is basically glue. My younger brother had pop-tarts or FruitLoops for breakfast, with a glass of orange juice alongside for Vitamin C (aka, his sugar with a side of more sugar). I always wanted to "be healthy", so I ate Raisin Bran, which has a whopping 18 grams of sugar per serving.

I don't disparage my parents for any of this, because it was what other parents were giving their kids, and it normalized what we grew up eating. These 'low fat' and 'whole wheat' choices were marketed to us as healthy and as consumers, we didn't ask questions.

We now know that spikes and crashes in blood sugar levels are associated with irritability, These kids were given enough sugar to power a car, and then medicated for their sugar rush.

I share this with you because marketing can be powerful. The way something is packaged (whether it be food, pharmaceutical options, messaging, political campaigning) is designed to focus on the superficial rather than the substantive. Advertising wise, how it looks is more important than what it is - time and time again.

Your choice is your voice, and the quality that you seek out matters. At Align, we strive to put out the highest quality product that we possibly can, with no false advertising.

There is no quick fix. There is no sustainable 2-week weight loss plan, no shortcut to healing, and no single adjustment that will take all your pain away.

Here's what we can do.

Help you to heal faster.

Teach you to eat smarter.

Help you build strength safely

Improve your biomechanics so you move better.

Enable you to stay active & healthy.

If you choose to work with us, I can promise you that you will learn something about your body that will serve you for the rest of your life.

If this speaks to you, I recommend responding to this email and setting up a quick, no-commitment discovery call with myself or a member of our team. We promise to listen before we speak, and to give our honest opinion about whether we are the right fit.

Ultimately, it's your choice.

Cheers to honest advertising,

Amanda

Biosphere

I have a friend from my time at McGill University who is a badass.

I've followed her career for a long time. While I went into the business of caring for people, she went into the business of caring for the world.

Alizé (um, best name ever) studied environmental conservation research and advocacy long before I knew what that entailed, and she is now a "National Geographic Explorer", which basically means she gets paid to travel to unique and diverse environmental research & conservation sites around the world. She is also getting a Ph.D in Climatopias (who knew that was a thing?!).

Anyway, she recently went to a place called 'Biopshere 2' in Arizona. Biosphere 2 started as a two year living experiment in a 3 acre glass dome that took place in the 1990s.

The intent of the experiment was to show that closed ecological systems would be able to support human life and allow them to thrive for space exploration.

The experiment had 7 biomes and 8 "Biospherans" who lived inside the following ecosystems: a rainforest, an ocean environment with a coral reef, a savannah grasslands, a wetlands, and a massive agricultural field where food was grown, plus a human workshop area.

Spoiler alert: The experiment failed. Among other things, dangerously high CO2 levels, dead pollinators, food supply shortages and weak trees showed that as humans, we are unable to recreate or replicate all that goes into our earth.

Anyway, the reason I am sharing this with you is that what resonated with me is that the reason the trees were unable to thrive: TREES NEED WIND RESISTANCE TO STRENGTHEN THEIR TRUNKS. (!!!!).

For a therapist like me, this was a revelatory moment. It makes perfect sense! It called to mind what doctors & therapists learn as 'Wolff's Law'. Wolff's Law states that "bones grow in the direction that they are loaded". In other words, THE WEAKEST SPINES are the ones that have NO RESISTANCE to fight against.

AKA - our spines are like trees. We need to WORK AGAINST RESISTANCE. We have to bend so that we don't break.

People tend to avoid exercise when they have any sort of back pain or injury because they are afraid that what they do will cause further damage. This is a myth, and a dangerous one at that.

I hear people voice concerns about arthritis, degenerative disc disease, back pain, fear of re-injury, fear of causing damage to the body -- meanwhile, trying to avoid these things is what causes these things.

I recommend you hop on a zero commitment discovery call with myself, or one of our team to learn if a Foundational Strength Program at Align is a good fit for you.

In this program, you will learn how to load your spine CORRECTLY and become proficient in the movement patterns that keep your 'trunk' (gotta keep the tree metaphor alive) strong.

If you have continued pain or are dealing with an active injury, you may need to work with a therapist first, and that's ok too - we will be honest about what we think will be the best choice for your health, and your body.

Respond to this email to set up a call, or click the link below to dive right in and schedule an appointment with Cole, or one of our other therapists.

I'll be over here channeling my inner tree. Strong, stoic and able to weather a storm, there are worse things to be than tree like.

Oh, and if you want to learn more about the wildness that is the Biosphere 2 experiment, there is a documentary on Hulu about it called Spaceship Earth.

Signing off from the biosphere (OG planet earth),

Amanda

Vacation Guilt

August 15, 2022

Well, I am back in the office after a magical few weeks on my honeymoon in Greece.

Womp womp.

I won’t lie, it is a bit sad to be back into a daily routine after so many days of adventure and spontaneity. Exploring without schedule or structure is vastly underrated.

I have to be honest though - it was a challenge to drop into “vacation mode”.

I couldn't figure it out. I would get up from my beach chair, restless, diving into the cool and refreshing water of the Aegean Sea, unable to escape the feeling that there was something I was supposed to be doing. It was akin to leaving the house feeling like you had forgotten to turn off the oven even though you had checked and rechecked five times before leaving.

The feeling was persistent, and lingered like a small mosquito (so many bites this month!) buzzing in my ear that I couldn’t shake. I couldn’t quite put my finger on what it was until a day had passed. Was it jetlag? Was it Covid?

Guilt! I was feeling guilty.

Guilty that I wasn’t working, guilty that I was not available to my patients at a moments notice, guilty that I was reneging on my responsibility as a business owner and leaving not only the town, but the country and multiple time zones to be completely and totally incommunicado.

It seems I had forgotten how to relax when it was not pre-booked on my schedule. My body was saying DO SOMETHING PRODUCTIVE! You don't have all day to lie around! When in fact I absolutely had all day to lie around. Nothing but time.

I couldn’t help but look around at all the Europeans on holiday, couples and families who were lounging and drinking and smoking and laughing, truly seeming like they hadn't a care in the world.

Did you know that 27 states in the European Union require their citizens to take one month off from working each year? It's GOVERNMENT MANDATED.

I'm starting to think the eatsleepworkrinserepeat mentality of the US is a touch too ingrained in us all.

With a holiday weekend coming up, and people making their returns back to school and routine, we’re all in danger feeling like there is somewhere else we need to be, something we should be doing, that we need to plan for what comes next.

If you are on vacation this week/weekend and feel unable to 'drop in' to vacation mode, remind yourself:

It is OK to rest.

It’s OK to do absolutely nothing productive, and just enjoy for the sake of enjoying.

I encourage you to luxuriate in it. Life will still be there when you get back, and you will be there to tend to it.

It took a day or so, but I managed to get past my vacation guilt once I had this epiphany, and had a DELIGHTFUL time. I came back feeling relaxed, recharged, and ready to do what I do best.

Happy long weekend!

In health and relaxation,

Amanda

Commitment

June 28, 2022

Big news: I am getting married on Sunday!

Marriage has thinking a lot about what it means to commit. I'll be honest, I haven't been the best at what I've committed to in the past.

There was the time I 'committed' to running a 10K, 'committed' to giving up dairy (lol), and 'committed' to a 1.5 hour morning routine before my workday.

I've 'committed' to 'never drinking again' after a particularly bad hangover. I've committed to reading academic journal articles every day to stay ahead of the curve professionally. I've committed to becoming one of those entrepreneurs who is part of the 5 AM club, and has a 16 hour workday.

I've failed at all of these commitments. Every single one. (But c'mon, who can resist a good cheese board?). Not the most promising track record for my upcoming commitment which just so happens to be my biggest commitment to date.

When I think back on those failures though, I think the problem isn't that I am bad at commitment - it was that I was committing to a task as opposed to a mindset. Commitment to a task is short-lived, even when successful. Commitment to a mindset, however, is about longevity.

"Giving up dairy" should have been - "I am going to commit to making better food choices."

I'm going to run a 10K" should have been - "I am going to start jogging 3x/week."

"I'm going to read journal articles daily" should have been - "I am going to prioritize my continuing education goals."

...and "I'm going to wake up every day at 5 AM" simply should not have existed at all. (I am not exactly a morning person).

If marriage was thought of as just a task, then every single marriage would fail. The task of 'getting married' is easy. It's simple paperwork that takes shockingly less time than it probably should IMO.

There are plenty of who commit to marriage, but they don't commit to the marriage mindset.

The marriage mindset is about committing to the big ideas that sustain a marriage and help it thrive. If you can't commit to trust, communication, patience and kindness with a healthy dose of 'whose turn it is to do the dishes' and 'hey, can you take the garbage out?', then how can a marriage be successful?

Our approach at Align is all about commitment to a mindset. We want you to move well, move often, and move without pain. Our goal is to create an environment and learning space that supports your muscles, bones and joints for the long haul. You only get one body, and it is up to you to choose how you care for it.

In the meantime, I am going to "commit" (really commit) to enjoying my wedding and honeymoon in Greece for the next couple of weeks.

In health and commitment,

Amanda